ID #314 Craniopharyngioma with Hydrocephalus in a 5-Year-Old Girl: A Case Report
Diko Anugrah Ramadhan, Nindy Putri Amalia, Syarifah LuthfianaAbstract
Background
Craniopharyngiomas are rare, benign epithelial tumors located in the sellar and suprasellar regions of the brain. They are particularly relevant in the pediatric population, where they account for approximately 5% to 10% of all intracranial tumors. The disease exhibits a bimodal age distribution, typically peaking in children between 5 and 14 years or younger than eighteen. These tumors commonly present with symptoms of increased intracranial presure due to hydrocephalus, along with visual disturbances and endocrine dysfunction. Management is exceptionally challenging given the tumor’s close proximity to critical neurovascular structures.
Methods
This case report details a 5-year-old girl who presented with a seven-month history of progressive headaches, recurrent seizures, and motor weakness. Neuroimaging confirmed a multilobulated suprasellar cystic mass extending into the ventricle, consequently causing hydrocephalus. The patient underwent an initial ventriculoperitoneal (VP) shunt placement, followed by a planned surgical safe resection.
Results
Following the VP shunt insertion, hydrocephalus symptoms improved, although the patient continued to experience recurrent seizures and neurological deficits. The surgical team successfully performed tumor debulking while preserving essential neurological function. Postoperative care was managed by a multidisciplinary team, focusing on controlling intracranial pressure, pain, and seizures. The patient showed gradual clinical improvement, achieving stabilization of vital signs and a decreased seizure frequency.
Conclusion
Pediatric suprasellar craniopharyngioma complicated by hydrocephalus presents significant diagnostic and therapeutic hurdles. This case underscores that early recognition, appropriate cerebrospinal fluid diversion, and a comprehensive multidisciplinary approach are essential for optimizing outcomes. Detailed perioperative care is crucial for managing these complicated pediatric brain tumors.