WITHDRAWN: Pediatric Giant Craniopharyngioma: Surgical Field Soak in Diluted Nimodipine Solution Reduces Cerebral Vasospasm
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Published on: August 11, 2015
Ying Yu1, Zeping Dong1, Dawei Chen1
1Department of Neurosurgery, First Hospital of Jilin University, Changchun, China.
Insights
This study reports the largest craniopharyngioma case ever documented. Successful surgical removal was achieved, and nimodipine infusion effectively resolved post-operative vasospasm.
Area of Science:
- Neuro-oncology
- Pediatric Neurosurgery
Background:
- Craniopharyngioma represents a significant portion of pediatric intracranial tumors.
- These tumors are typically slow-growing and benign.
Observation:
- A giant cystic craniopharyngioma, measuring 9.2 x 8.7 x 7.0 cm with calcification, was identified in the suprasellar cistern.
- This case represents the largest craniopharyngioma documented in medical literature.
- Post-surgical vasospasm occurred in the operative field.
Findings:
- Surgical removal of the giant craniopharyngioma was completed.
- Topical application of diluted nimodipine solution reversed the vasospasm, including in the optic nerve and middle cerebral artery.
- Three-month follow-up showed no residual tumor or recurrence, with only minor subdural hygroma.
Implications:
- Highlights the successful management of exceptionally large craniopharyngiomas in pediatric patients.
- Demonstrates the efficacy of nimodipine in managing surgical vasospasm in neurosurgery.
- Provides a benchmark for surgical outcomes in pediatric craniopharyngioma cases.
Abstract:
Craniopharyngioma is a slow-growing benign tumor, accounting for 5.6%-13% of primary intracranial tumors in children. The present patient showed a huge cyst, and computed tomography scan of the brain revealed a 9.2- × 8.7- × 7.0-cm giant cystic lesion with calcification located in the suprasellar cistern. A review of the literature showed the present case is the biggest craniopharyngioma reported. After the tumor was removed, vasospasm appeared in the surgical area. The surgical field was soaked in diluted nimodipine solution for 12 minutes, including the exposed nerve and blood vessel, especially the optic nerve and middle cerebral artery, which led to vasospasm recovery. At 3-month follow-up, there was slight subdural hygroma; contrast magnetic resonance imaging scan did not reveal any residual tumor or recurrence.
