Boekhoff Svenja, Bison Brigitte, Genzel Daniela, Eveslage Maria, Otte Anna, Friedrich Carsten, Flitsch Jörg, Müller Hermann L
Department of Pediatrics and Pediatric Hematology/Oncology, University Children's Hospital, Carl von Ossietzky University, Klinikum Oldenburg AöR, Oldenburg, Germany.
Department of Neuroradiology, University Hospital Würzburg, Würzburg, Germany.
Front Oncol. 2021 Jul 14;11:698150. doi: 10.3389/fonc.2021.698150. eCollection 2021.
Cerebral infarction (CI) is a known vascular complication following treatment of suprasellar tumors. Risk factors for CI, incidence rate, and long-term prognosis are unknown for patients with childhood-onset craniopharyngioma (CP).
MRI of 244 CP patients, recruited between 2007 and 2019 in KRANIOPHARYNGEOM 2007, were reviewed for CI. Risk factors for CI and outcome after CI were analyzed.
Twenty-eight of 244 patients (11%) presented with CI based on reference assessment of MRI. One CI occurred before initial surgery and one case of CI occurred after release of intracystic pressure by a cyst catheter. 26 of 28 CI were detected after surgical tumor resection at a median postoperative interval of one day (range: 0.5-53 days). Vascular lesions during surgical procedures were documented in 7 cases with CI. No relevant differences with regard to surgical approaches were found. In all 12 irradiated patients, CI occurred before irradiation. Multivariable analyses showed that hydrocephalus and gross-total resection at the time of primary diagnosis/surgery both were risk factors for CI. After CI, quality of life (PEDQOL) and functional capacity (FMH) were impaired.
CI occurs in 11% of surgically-treated CP cases. Degree of resection and increased intracranial pressure are risk factors, which should be considered in the planning of surgical procedures for prevention of CI.
脑梗死（CI）是鞍上肿瘤治疗后已知的血管并发症。儿童期颅咽管瘤（CP）患者发生CI的危险因素、发病率和长期预后尚不清楚。
回顾了2007年至2019年在KRANIOPHARYNGEOM 2007研究中招募的244例CP患者的MRI，以评估CI情况。分析了CI的危险因素及CI后的结局。
根据MRI的参考评估，244例患者中有28例（11%）出现CI。1例CI发生在初次手术前，1例CI发生在通过囊肿导管释放囊内压力后。28例CI中有26例在手术切除肿瘤后被检测到，术后中位间隔时间为1天（范围：0.5 - 53天）。7例发生CI的患者在手术过程中有血管病变记录。未发现手术方式有相关差异。在所有12例接受放疗的患者中，CI发生在放疗前。多变量分析显示，脑积水和初次诊断/手术时的全切均为CI的危险因素。发生CI后，生活质量（PEDQOL）和功能能力（FMH）均受损。
11%接受手术治疗的CP病例会发生CI。切除程度和颅内压升高是危险因素，在预防CI的手术规划中应予以考虑。
