Long term neuropsychological evaluation of adult patients with craniopharyngiomas.

INTRODUCTION: Craniopharyngiomas are benign tumors that develop in the hypothalamic-pituitary region. Their treatment mainly involves surgery, sometimes combined with radiotherapy. The hypothalamus plays an essential role in hormonal balance and energy regulation, but also in cognition through connectivity circuits. The cognitive impact of craniopharyngioma treatment is poorly understood and has mainly been studied in children. PATIENTS AND METHODS: We report the neuropsychological assessments of 22 adult patients treated for craniopharyngioma with a follow-up of at least 5 years, 16 of whom were diagnosed while being adults. All assessments were performed by a neuropsychologist using validated tests. More than 65% of patients, including those diagnosed in adulthood, showed at least one impairment in executive functioning, especially cognitive inhibition or deficit in organization. 75% of patients reported fatigue. For half of these patients, these impairments needed specific treatment like cognitive rehabilitation. CONCLUSION: Neuropsychological evaluation has to be part of the follow-up of patients treated for a craniopharyngioma including those diagnosed during adulthood.