Neurocognitive functioning of patients treated for pediatric craniopharyngioma and predictors of outcomes

Craniopharyngioma is a rare pediatric brain tumor that is often treated with surgical resection and radiation therapy, all of which can have significant impacts on cognitive abilities. The objectives of the current study were to characterize the neurocognitive functioning of pediatric patients that have been treated for craniopharyngioma and examine the impact of medical, demographic, and treatment variables on neurocognitive outcomes. We completed retrospective chart reviews to collect medical, demographic, and neurocognitive data for 27 patients that were treated for craniopharyngioma and underwent follow-up neuropsychological evaluation. Bivariate correlations revealed that preoperative hydrocephalus was associated with worse performance in IQ, working memory, verbal fluency, learning memory, recall memory, and memory recognition. Patients with hydrocephalus did significantly worse than those without hydrocephalus in almost all cognitive domains. Those who underwent surgical resection via the endoscopic endonasal approach (vs. craniotomy) did significantly worse on recall memory and processing speed. No significant correlations or differences were observed between neurocognitive outcomes and age at treatment, extent of surgical resection, time elapsed since surgery, new hypothalamic injuries, new endocrinopathies, or radiation treatment history. These data suggest hydrocephalus is a key predictor of neurocognitive outcomes among patients treated for craniopharyngioma, with surgery factors also contributing to outcomes. Larger studies are needed to understand the individual risk factors for cognitive impacts within this patient population.