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      Craniopharyngioma: a review of long-term visual outcome.

      Clinical & Experimental Ophthalmology
      Adolescent, Adult, Aged, Child, Child, Preschool, Craniopharyngioma, complications, diagnosis, pathology, physiopathology, surgery, Female, Follow-Up Studies, Fundus Oculi, Hemianopsia, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasm Recurrence, Local, Pituitary Neoplasms, Postoperative Complications, Retrospective Studies, Tomography, X-Ray Computed, Treatment Outcome, Vision Disorders, Vision, Ocular, Visual Acuity, Visual Fields

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          Abstract

          To assess the clinical presentation and long-term visual outcome in a series of patients with craniopharyn-gioma. Retrospective case review. Thirty-six patients were reviewed, comprising 19 female patients and 17 male patients. The age range was 2-77 years with a bimodal distribution of 17 children (mean age 10 years) and 19 adults (mean age 47 years). Blurred vision was the most common visual complaint (23 cases, 64%) and headache the most frequent systemic complaint (19 cases, 53%). The average duration of systemic symptoms was 45 weeks compared to 10 weeks for visual symptoms. Deficits in visual acuity occurred in 13 patients (36%) and showed no significant change from initial presentation to final review. Sixteen patients (44%) had bitemporal hemianopia on presentation and pleomorphism (change from one type of visual field defect to another) occurred in 11 patients. Recurrence of tumour occurred in 15 patients (42%) and was more likely in children (59%) than adults (26%). The mean time period to recurrence was 7 years. The average follow-up period for all cases was 10 years. Patients with craniopharyngioma generally present late, and the visual symptoms are often preceded by a long history of systemic symptoms. Children are more likely to present with systemic symptoms than adults. Visual field pleomorphism is a feature of craniopharyngioma and occurred in one-third of the patients. Local recurrence is common. Although magnetic resonance imaging is the recommended means of follow up, regular neuro-ophthalmic review is useful in the early detection of anterior visual pathway compression by recurrent tumour.

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