Cognitive and behavioral changes in children with craniopharyngioma before and after surgery

Objective To explore the differences of brain cognitive function and behavior in children with craniopharyngioma during perioperative period. Methods The clinical data of 19 patients with craniopharyngioma were retrospectively enrolled who underwent craniotomy at Department of Neurosurgery, Tsinghua University Yuquan Hospital from February 2015 to February 2017. The mean age of patients was 9.10±3.53 (6-15) years old. Twelve cases were primary tumors and 7 were recurrent tumors. Craniotomy was conducted for tumor resection in all patients. Fourteen cases were treated through frontal coronal incision approach, 3 through corpus callosum -transparent compartment-dome approach and 2 through small incision of pterional approach. The intelligence test was performed using the fourth edition of the Wechsler Intelligence Test Scale before and after surgery. The Conners Child Behavior Scale (for parents) was used for behavioral testing. The cognitive function and behavioral changes of the brain in 19 children with craniopharyngioma before and 2 weeks after operation were compared. Results Among the 19 children with craniopharyngiomas, total tumor resection was achieved in 17 cases and subtotal resection in 2. There was no operative death. The preoperative and postoperative total IQ (intelligence quotient) scores (101.68±18.50 vs. 103.05±15.67), verbal comprehension indexes(98.00±13.51 vs. 101.00±17.07), perceptual reasoning indexes (94.11±12.60 vs. 95.26±15.05), working memory indexes (87.00±14.15 vs. 92.16±19.12), processing speed indexes (92.95±17.17 vs. 95.47±16.91) had no significant difference (all P>0.05). There were no significant differences in behavior scores of the children before and 2 weeks after operation (all P>0.05). Conclusion There seems to be no significant decrease in postoperative intelligence and behavioral level in children with craniopharyngioma. It shows that the surgical resection itself would not cause damage to the cognitive function of the child. Key words: Craniopharyngioma; Child; Cognition; Child behavior; Neurosurgical procedures