Investigators from Carl von Ossietzky University, Oldenburg, and other centers in Germany, compared cognitive performance in a group of 15 patients with childhood craniopharyngioma and hypothalamic involvement and a group of 24 age- and intelligence-matched control subjects. IQ scores were mostly in the average range and not significantly different in patients and controls. Patients had significantly lower performance scores in tests of memory and executive functioning. Delayed recall performance was severely impaired in one-third of the patients. Compared with patients with low-grade hypothalamic involvement, those with high-grade involvement showed worse performance in executive functions and reduced functional aptitude for daily life actions. Preoperatively, only 1 patient was severely obese; postoperatively, most patients were obese, a sign of hypothalamic dysfunction. [1]

COMMENTARY. Craniopharyngioma, a histologically benign tumor, may invade the hypothalamus, mammillary bodies, pituitary, and optic nerves. Sequelae of the tumor or its removal include visual field defects, obesity, and neurobehavioral deficits. Hypothalamic obesity in 46% of 24 cases of craniopharyngioma treated at the Phoenix Children's Hospital was refractory to current management options and accounted for increased mortality [2]. The development of obesity is influenced by premorbid obesity, genetics, and therapy received, especially radiation.