Microsurgery of the hypothalamus with special reference to craniopharyngioma

After a short survey of microanatomy, microtopography, neurophysiology and neuropathophysiology of the hypothalamus the surgical approaches to the hypothalamus with special reference to the craniopharyngiomas are described in detail. Based on 100 personal cases (1954-1979) the special procedure, depending on the site and extent of the tumour and its involvement of the hypothalamus, is discussed. Primary radical excision (19 cases) with a mortality rate of 10.5% seems to be the method of choice, as late mortality recurrences and secondary operations are frequent after non-radical procedures. Modern microsurgical technique promises to achieve primary radical excision more frequently and with less risk.