Frontal lobe lesions and cognitive function in craniopharyngioma survivors

We performed neuropsychological testing using the Luria-Nebraska Neuropsychological Battery, computed tomography, and magnetic resonance imaging (MRI) in four patients one to 15 years after surgery and radiation therapy for childhood craniopharyngioma. Of three patients with impairment of frontal lobe-mediated cognitive function, two had extensive areas of prolonged spin-lattice and spin-spin relaxation times in the frontal lobes demonstrated by MRI, and one had a lipid accumulation in the anterior horn of the right lateral ventricle and beneath a burrhole defect in the skull. One patient with minimal cognitive dysfunction had no abnormality in imaging studies. We believe assessment of neuropsychological status is an important aspect of the evaluation of children with craniopharyngioma. We have found the Luria-Nebraska Neuropsychological Battery and MRI to be particularly useful in this evaluation.