Surgery of the Skull Base by Alexander König & Uwe Spetzger

Author:Alexander König & Uwe Spetzger
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Preoperative Medical Management

Good medical management of the craniopharyngioma patient is crucial to the overall outcome. In addition to undergoing extensive preoperative endocrinological investigations (◘ Table 5.8), specific attention must also be paid to the intraoperative and postoperative endocrinological status of the patient.

Diabetes insipidus (DI) occurs preoperatively in 6–38% and must be ruled out or confirmed (◘ Table 5.8).

Unless the tumor is small, all craniopharyngioma patients are presumed to be deficient in ACTH and supplemented with corticosteroids preoperatively. Hypocortisolism is potentially lethal, and dexamethasone is mandatory for patients presenting with adrenal dysfunction. In addition, steroids are also indicated if a perifocal vasogenic edema is present around the tumor.

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