© 2008 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business
http://www.psypress.com/jcen DOI: 10.1080/13803390802064599
JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY
2009, 31 (1), 140–144
NCEN
Neuropsychological functioning following
craniopharyngioma removal
Outcome Following Craniopharyngioma Removal
Harry N. Bawden,
1,2
Sonia Salisbury,
2
Gail Eskes,
3
and Rachel Morehouse
4
1
Department of Psychology, IWK Health Centre, Halifax, Nova Scotia, Canada
2
Department of Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada and
Dalhousie University, Halifax, Nova Scotia, Canada
3
Department of Psychology, Queen Elizabeth II Health Sciences Centre, Halifax,
Nova Scotia, Canada
4
Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
The neuropsychological functioning of patients who had undergone surgical removal of craniopharyngiomas was
compared to that of an endocrine control group composed of patients with nontumor hypopituitarism, an obese
control group, and a normal control group. Neuropsychological assessments consisting of measures of intelligence,
memory, attention, and executive functioning were carried out. The craniopharyngioma group had lower
Performance IQ than did the normal control group, but their Performance IQ was comparable to that of the
hypopituitarism and obese control groups. The craniopharyngioma patients did not differ in Verbal or Full Scale
IQs from the remaining groups. There were no group differences on measures of verbal or nonverbal memory,
ability to sustain attention, or executive functioning including measures of verbal or figural fluency, nonverbal
problem solving, ability to copy a complex geometric figure, and visual motor and visual sequencing skills. The
group mean scores on the measures of intelligence and neuropsychological abilities for the craniopharyngioma
patients were in the low-average to average range. While craniopharyngioma patients can have significant morbidity
including endocrine and visual deficits as well as obesity resulting from hyperphagia, neuropsychological
deficits are not always present. Their neuropsychological outcome is more benign than some previous studies have
suggested.
Keywords: Craniopharyngioma; Outcome; Neuropsychology; Executive functioning; Intelligence.
Craniopharyngiomas account for approximately
1 to 4% of intracranial tumors and about 6 to 9%
of childhood brain tumors. Although they are
benign, their location near the hypothalamus,
optic tracts, and pituitary stalk and their tendency
to adhere to and infiltrate surrounding tissue
sometimes make them difficult to completely
remove, without sacrificing adjunct brain struc-
tures (Hoffman, 1994; Sanford & Muhlbauer,
1991). An attempt at total resection, sometimes
followed by additional surgery or radiotherapy
following tumor recurrence, appears to be the most
prevalent treatment approach.
There have been several studies that have exam-
ined tumor recurrence, morbidity, and mortality
following surgical treatment of craniopharyngiomas
(e.g., Duff et al., 2000; van Effenterre & Boch,
2002). Well-recognized sequelae of the disruptive
presence of the tumor and treatment for crani-
opharyngioma include endocrine deficits (Curtis,
Daneman, Hoffman, & Ehrlich, 1994; DeVile, Grant,
Hayward, & Stanhope, 1996), due to hypothalamic/
Portions of this paper were presented at the International Neuropsychological Society meeting, Chicago, February, 2001. This work
was funded by a grant from the IWK Health Centre. The authors would like to thank the participants, N. Ciccarelli and G. Dragone,
for completing the assessments, C.A. Armour for organizing the project and scheduling participants, and D. Carr for manuscript
preparation.
Address correspondence to Harry N. Bawden, IWK Health Centre, 5850/5980 University Avenue, PO Box 9700, Halifax, Nova Scotia,
Canada B3K 6R8 (E-mail: harry.bawden@iwk.nshealth.ca).