Craniopharyngiomas (CPs) are rare brain tumours managed primarily with surgery and radiotherapy. There are two phenotypes of CPs, one with a rather good outcome without hypothalamic damage and the other with hypothalamic damage. With hypothalamic damage progressive disease with recurrent operations and additional cranial radiotherapy often result in hypothalamic obesity, affected psychosocial life and cognitive dysfunction. The morbidity and mortality is increased for particularly cerebrovascular diseases. Preoperative hypothalamic involvement to predict hypothalamic damage is important for decision making for hypothalamic sparing surgery. Also postoperative hypothalamic damage evaluation with the use of hypothalamus volume measurement can predict hypothalamic obesity, which is important for early treatment options. The morbidity of CPs includes cognitive dysfunction with attention deficits, impaired episodic memory and processing speed. Again patients with hypothalamic damage are more affected. Treatment options of hypothalamic obesity in the chronic phase are scarce and not convincingly successful. The most optimal situation is to try to hinder or stop hypothalamic obesity to evolve. Prevention of hypothalamic damage is recommended, with special regard to hypothalamus-sparing therapeutic approaches that respect the integrity of essential nuclei located in both the medial and the posterior hypothalamic areas.


中文翻译：

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颅咽管瘤下丘脑损伤的诊断，背景和治疗。

颅咽管瘤（CP）是罕见的脑肿瘤，主要通过手术和放射疗法治疗。CP有两种表型，一种具有下丘脑损害的相当好的结果，另一种具有下丘脑损害。下丘脑损伤伴进行性手术的进行性疾病和反复进行的颅脑放疗通常会导致下丘脑肥胖，影响社会心理生活和认知功能障碍。特别是脑血管疾病的发病率和死亡率增加。术前下丘脑受累可预测下丘脑损害对于下丘脑保留手术的决策至关重要。此外，使用下丘脑体积测量评估术后下丘脑损害可预测下丘脑肥胖，这对早期治疗选择至关重要。CP的发病率包括认知功能障碍，注意力缺陷，情景记忆受损和处理速度降低。下丘脑损伤的患者再次受到更大的影响。慢性期下丘脑肥胖症的治疗选择很少，而且不能令人信服地取得成功。最理想的情况是试图阻止或阻止下丘脑肥胖的发展。建议预防下丘脑损伤，尤其要注意保留下丘脑的治疗方法，该方法应尊重位于下丘脑内侧和后部的基本核的完整性。慢性期下丘脑肥胖症的治疗选择很少，而且不能令人信服地取得成功。最理想的情况是试图阻止或阻止下丘脑肥胖的发展。建议预防下丘脑损伤，尤其要注意保留下丘脑的治疗方法，该方法应尊重位于下丘脑内侧和后部的基本核的完整性。慢性期下丘脑肥胖症的治疗选择很少，而且不能令人信服地取得成功。最理想的情况是试图阻止或阻止下丘脑肥胖的发展。建议预防下丘脑损伤，尤其要注意保留下丘脑的治疗方法，该方法应尊重位于下丘脑内侧和后部的基本核的完整性。