GIANT CRANIOPHARYNGIOMA WITH BLINDNESS REVERSED BY SURGERY

A 3-year-old boy presented with a 3-day history of total blindness. Th ere were no features of raised intracranial pressure or endocrine dist urbance. Magnetic resonance imaging of the brain showed a giant cranio pharyngioma measuring 5 x 3 cm. It was located in the suprasellar regi on and produced a mass effect with compression of the III and both lat eral ventricles. The tumour extended downwards into the pituitary foss a. Urgent surgical decompression and subtotal excision of the tumour r esulted in complete visual recovery in the right eye. The left eye rem ained blind. The blindness might have been caused by direct pressure o n the optic nerves and chiasma by the tumour. The lack of visual recov ery in the left eye may be the consequence of additional ischaemic ins ult to the left optic nerve. It is concluded that surgical decompressi on should be carried out in a patient with a giant craniopharyngioma p resenting with total blindness before the condition is considered hope less.