STUDY OF CRANIOPHARYNGIOMA THE CHILD .1. PREOPERATIVE AND POSTOPERATIVE SEMIOLOGY AND PSYCHOPATHOLOGY

Craniopharyngioma is a benign tumor located in the diencephalon, mostl y diagnosed during childhood After surgery, all the children suffer fr om panhypopituitarism that needs hormonal suppletive therapy. Some chi ldren exhibit a major hyperphagia, regularly combined with other behav ioral and mood disorders, suggesting that a specific psychosyndrome mi ght be the consequence of lesions in the ventromedal area of the hypot halamus. The psychosocial prognosis of these children is dramatically affected not only because of the progressive obesity but also as the c onsequence of complex cognitive and affective modifications in their m ental functionning. This paper outlines our preliminary results of a p rospective study in children before and after surgery for a craniophar yngioma. The clinical aspects of the psychosyndrom are described and a nalyzed with respect to psychopathological considerations. Because of the established presence of lesions in structures that are involved in important homeostatic regulation (hunger thirst, thermoregulation, ho rmonal secretion), discussion of psychopathology must adress the relat ionships between specific cerebral damage and changes in behavior Fina lly, a better understanding of these links could be beneficial for the children, for whom there is no current applicable therapeutic solutio n.