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 hemorrhages with removal of external ventricular drains. 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 1)

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 2).

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.
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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