The records of 20 children with craniopharyngioma seen between 1983 and 1995 were reviewed at the University of Colorado Health Sciences Center, Children’s Hospital, and the Denver VA Medical Center, CO. Post-surgical social behavior and school performance were assessed by neuropsychological tests and standardized rating scales over a mean follow-up period of 38 months. Moderate or severe impairment of neurobehavior occurred in 12 (60%), and only 3 had a good outcome. The outcome was independent of partial or gross total resection of the tumor. The possible adverse effects of radiation therapy used in 17 (85%) could not be evaluated, but the age at the time of irradiation and the degree of dysfunction were not related. The common feature of the tumors was location in diencephalic and adjacent limbic regions, and the direct involvement of these structures appeared to correlate with neurobehavioral impairments. 
COMMENT. Behavioral assessments in addition to psychological testing are important in the pre- and post-surgical and -irradiation treatment of craniopharyngioma. The cognitive effects of cranial irradiation in children with acute lymphoblastic leukemia are reviewed in Progress in Pediatric Neurology III, PNB Publishers, 1997;pp424-6).