The patient came to the clinic 25-January-2002 complaining of headache with blurred vision for more than 1 year with progressive course. CT-scan of the drain was done 11-October-2000 reported as having hydrocephalus.

MRI of the brain done recently showing huge craniopharyngioma with massive intraventricular and retrosellar extension.

On examination: The patient has left sided hemiparesis.

Bifrontal craniotomy with mobilization and preservation of the olfactory tracts was achieved. The tumor mass was seen under the chiasm and it was resected in piece meal fashion. Radical resection was achieved. It was necessary to create small flap at the base of the bone defect, over the nasion and drill the posterior part of the tuberculum sella, to gain better exposure of the intraventricular part of the tumor from under the chiasm. The basilar artery was seen and the Liliquest membrane not violated. Papaverine irrigation was used all the time to avoid arterial spasm.  The pituitary stalk was shifted to the right. All the vascular structures were preserved.

Routine closure of the wound. The patient was kept in ventilator for 24 hours after then he showed acceptable recovery and was discharge after one week.

The patient was seen several times in the clinic after  surgery and control MRI was done 07-March-2002 and 18-May-2002 were the same confirming radical resection of the tumor. The patient did not show diabetes insipidus nor pituitary insufficiency. The pituitary stalk and the olfactory tracts were anatomically and functionally preserved. The weakness left side disappeared.

It was advised for precaution. to be followed by endocrine specialist and undergo radiotherapy to prevent future recurrence.

The patient had huge craniopharyngioma causing secondary hydrocephalus. Radical resection is the best goal to achieve in this case.

For more details, please visit: http://craniopharyngiomas.com/