====== Craniopharyngioma case reports ======


Fulkerson et al. describe a 12-year-old female who experienced a number of complications after a [[craniopharyngioma]] resection. The patient suffered multiple new [[intraventricular hemorrhage]]s with removal of [[external ventricular drain]]s. Standard [[coagulopathy]] tests did not reveal any abnormalities. However, an abnormal [[Thromboelastography]] (TEG) value suggested primary [[hyperfibrinolysis]], which led to a change in medical management. The patient did not suffer any further bleeding episodes after the change in treatment.

The authors discuss a case where TEG influenced patient management and identified a problem despite normal values of standard [[laboratory]] tests. Neurosurgeons should be aware of the potential benefits for TEG testing in pediatric patients
((Fulkerson DH, Weyhenmeyer J, Archer JB, Shaikh KA, Walsh M.
Thromboelastography-Guided Therapy of Hemorrhagic Complications after
Craniopharyngioma Resection: Case-Based Update. Pediatr Neurosurg. 2019 Aug
7:1-8. doi: 10.1159/000501117. [Epub ahead of print] Review. PubMed PMID:
31390646.
))
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Alvarez-Garijo et al. presented two cases of giant, ossified, [[craniopharyngioma]] in paediatric patients; one was subtotally (more than 90%) and the other, totally resected, both by a transfrontal-nasal approach. The results have been excellent, with total clinical recovery, olfactory function preserved and no cosmetic sequelae
((Alvarez-Garijo JA, Cavadas P, Vila M, Fabregat J, Alvarez A. Craniopharyngioma
in children. Surgical treatment by a transbasal anterior approach. Childs Nerv
Syst. 1998 Dec;14(12):709-12. PubMed PMID: 9881623.
)).
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A 41-year-old man in whom a large suprasellar craniopharyngioma producing severe visual loss was not detected by computed tomography but was easily identified with magnetic resonance imaging. Thus, despite high-resolution computed tomographic scans, large suprasellar craniopharyngiomas can be missed. Magnetic resonance imaging may be superior to computed tomography in detecting these tumors
((Johnson LN, Hepler RS, Yee RD, Frazee JG, Simons KB. Magnetic resonance imaging of craniopharyngioma. Am J Ophthalmol. 1986 Aug 15;102(2):242-4. doi: 10.1016/0002-9394(86)90152-2. PMID: 3740186.)).