{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:01:55Z","timestamp":1787025715172,"version":"build-2736575974"},"reference-count":146,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2010,4]]},"abstract":"\n Object<\/jats:title>\n Controversy persists concerning the optimal treatment of craniopharyngiomas in children, and no standard outcome metric exists for comparison across treatment modalities, nor is there one that adequately reflects the multisystem dysfunction that may arise.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The authors retrospectively analyzed the records of 86 consecutive children who underwent a uniform treatment paradigm of attempted radical resection performed by a single surgeon. Excluding 3 perioperative deaths and 3 patients with inadequate follow-up, 80 children (34 girls and 46 boys; mean age 9.56 years; mean follow-up 9.6 years) composed the study group (53 primary and 27 previously treated\/recurrent tumors). Building on existing classification schemes proposed by De Vile for hypothalamic dysfunction and Wen for overall functional outcome, the authors devised a more nuanced classification system (Craniopharyngioma Clinical Status Scale [CCSS]) that assesses outcome across 5 axes, including neurological examination, visual status, pituitary function, hypothalamic dysfunction, and educational\/occupational status at last follow-up (there is a 4-tiered grading scale in each domain, with increasing values reflecting greater dysfunction).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There was a significant increase in pituitary dysfunction following treatment\u2014consistent with the high rates of diabetes insipidus and hypopituitarism common to the surgical management of craniopharyngiomas\u2014and less dramatic deterioration in hypothalamic function or cognitive domains. Significant improvement in vision was also demonstrated, with no significant overall change in neurological status. Preoperative CCSS scores predicted postoperative outcome better than clinical characteristics like patient age, sex, tumor size, and the location or presence of hydrocephalus.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Preoperative CCSS scores predicted outcome with higher accuracy than clinical or imaging characteristics. In lieu of randomized trials, the CCSS may provide a useful outcome assessment tool for comparison across treatment paradigms and surgical approaches. Long-term follow-up is critical to the analysis of outcomes of craniopharyngioma treatment, given the often-delayed sequelae of all therapies and the high recurrence rates of these tumors.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2010.2.focus09304","type":"journal-article","created":{"date-parts":[[2010,4,1]],"date-time":"2010-04-01T10:20:01Z","timestamp":1270117201000},"page":"E2","source":"Crossref","is-referenced-by-count":43,"title":["Craniopharyngioma Clinical Status Scale: a standardized metric of preoperative function and posttreatment outcome"],"prefix":"10.3171","volume":"28","author":[{"given":"Robert E.","family":"Elliott","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen A.","family":"Sands","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell G.","family":"Strom","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey H.","family":"Wisoff","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Pediatrics, New York University School of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0280002","series-title":"Br J Cancer","first-page":"255","article-title":"Cognitive and academic outcome following cranial irradiation and chemotherapy in children: a longitudinal study","volume":"82","author":"Anderson","year":"2000"},{"key":"b2-0280002","series-title":"J Clin Exp Neuropsychol","first-page":"684","article-title":"Impairments of attention following treatment with cranial irradiation and chemotherapy in children","volume":"26","author":"Anderson","year":"2004"},{"key":"b3-0280002","series-title":"J Neurosurg","first-page":"547","article-title":"The descriptive epidemiology of craniopharyngioma","volume":"89","author":"Bunin","year":"1998"},{"key":"b4-0280002","series-title":"Childs Nerv Syst","first-page":"747","article-title":"Long-term results of the surgical treatment of craniopharyngioma: the experience at the Policlinico Gemelli, Catholic University, Rome","volume":"21","author":"Caldarelli","year":"2005"},{"key":"b5-0280002","series-title":"Neurosurgery","first-page":"382","article-title":"Craniopharyngiomas in children","volume":"11","author":"Carmel","year":"1982"},{"key":"b6-0280002","series-title":"Neurosurgery","first-page":"1053","article-title":"Memory deficits among children with craniopharyngiomas","volume":"49","author":"Carpentieri","year":"2001"},{"key":"b7-0280002","series-title":"J Neurosurg","first-page":"409","article-title":"Neurological and psychophysiological sequelae following different treatments of craniopharyngioma in children","volume":"59","author":"Cavazzuti","year":"1983"},{"key":"b8-0280002","series-title":"J Neurosurg","first-page":"650","article-title":"Longterm neurological, visual, and endocrine outcomes following transnasal resection of craniopharyngioma","volume":"102","author":"Chakrabarti","year":"2005"},{"issue":"Suppl 1","key":"b9-0280002","series-title":"Neurochirurgie","first-page":"147","article-title":"Le craniopharyngiome de l'enfant de moins de 5 ans","volume":"37","author":"Choux","year":"1991"},{"key":"b10-0280002","series-title":"Psychoneuroendocrinology","first-page":"365","article-title":"Postsurgical IQ and behavioral data on twenty patients with a history of childhood craniopharyngioma","volume":"2","author":"Clopper","year":"1977"},{"key":"b11-0280002","series-title":"Neurosurgery","first-page":"539","article-title":"Variations on the standard transsphenoidal approach to the sellar region, with emphasis on 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pediatric series","volume":"19","author":"Di Rocco","year":"2006"},{"key":"b16-0280002","series-title":"Pituitary","article-title":"Multiple head and neck tumors following treatment for craniopharyngioma","author":"Dobracki","year":"2009"},{"key":"b17-0280002","series-title":"Neurosurgery","first-page":"291","article-title":"Long-term outcomes for surgically resected craniopharyngiomas","volume":"46","author":"Duff","year":"2000"},{"key":"b18-0280002","series-title":"Neurologist","first-page":"293","article-title":"Long-term effects of radiation therapy on cognitive and endocrine function in children with leukemia and brain tumors","volume":"10","author":"Duffner","year":"2004"},{"key":"b19-0280002","series-title":"Neurosurgery","first-page":"638","article-title":"Factors affecting intellectual outcome in pediatric brain tumor patients","volume":"21","author":"Ellenberg","year":"1987"},{"key":"b20-0280002","series-title":"J Neurosurg Pediatr","first-page":"30","article-title":"Efficacy and safety of radical resection of primary and recurrent craniopharyngiomas in 86 children","volume":"5","author":"Elliott","year":"2010"},{"key":"b21-0280002","series-title":"J Neurosurg Pediatr","first-page":"276","article-title":"Minimal residual calcification and recurrence after gross-total resection of craniopharyngioma in children","volume":"3","author":"Elliott","year":"2009"},{"key":"b22-0280002","series-title":"J Neurosurg Pediatr","first-page":"105","article-title":"Surgical treatment of ectopic recurrence of craniopharyngioma. 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Prognosis","volume":"2","author":"Rankin","year":"1957"},{"key":"b54-0280002","series-title":"Int J Radiat Oncol Biol Phys","first-page":"611","article-title":"Pediatric craniopharyngiomas: long term results of combined treatment with surgery and radiation","volume":"24","author":"Regine","year":"1992"},{"key":"b55-0280002","series-title":"Childs Nerv Syst","first-page":"179","article-title":"Late neuropsychological and behavioural outcome of children surgically treated for craniopharyngioma","volume":"14","author":"Riva","year":"1998"},{"key":"b56-0280002","series-title":"Eur J Clin Nutr","first-page":"13","article-title":"Body Mass Index variations: centiles from birth to 87 years","volume":"45","author":"Rolland-Cachera","year":"1991"},{"key":"b57-0280002","series-title":"Childs Nerv Syst","first-page":"691","article-title":"Craniopharyngioma: the pendulum of surgical management","volume":"21","author":"Sainte-Rose","year":"2005"},{"issue":"4 Suppl","key":"b58-0280002","series-title":"J Neurosurg","first-page":"302","article-title":"Quality of life and behavioral follow-up study of pediatric survivors of craniopharyngioma","volume":"103","author":"Sands","year":"2005"},{"key":"b59-0280002","series-title":"NeuroRehabilitation","first-page":"199","article-title":"Limitations of neuropsychological testing to predict the cognitive and behavioral functioning of persons with brain injury in real-world settings","volume":"16","author":"Sbordone","year":"2001"},{"key":"b60-0280002","series-title":"J Clin Endocrinol Metab","first-page":"3149","article-title":"Assessment of the hypothalamo-pituitary-adrenal axis in patients treated with radiotherapy and chemotherapy for childhood brain tumor","volume":"88","author":"Schmiegelow","year":"2003"},{"key":"b61-0280002","series-title":"J Neurosci Nurs","first-page":"220","article-title":"Late effects associated with treatment of craniopharyngiomas in childhood","volume":"22","author":"Shiminski-Maher","year":"1990"},{"key":"b62-0280002","series-title":"J Head Trauma Rehabil","first-page":"973","article-title":"Ecological validity of neuropsychological assessment in childhood traumatic brain injury","volume":"15","author":"Silver","year":"2000"},{"key":"b63-0280002","series-title":"Childs Nerv Syst","first-page":"660","article-title":"Craniopharyngioma in childhood: our evidence-based approach to management","volume":"21","author":"Thompson","year":"2005"},{"key":"b64-0280002","series-title":"J Neurosurg","first-page":"3","article-title":"Craniopharyngioma in adults and children: a study of 122 surgical cases","volume":"97","author":"Van Effenterre","year":"2002"},{"key":"b65-0280002","series-title":"Childs Nerv Syst","first-page":"628","article-title":"Origin of craniophar yngiomas: implication on the growth pattern","volume":"21","author":"Wang","year":"2005"},{"key":"b66-0280002","series-title":"Neurosurgery","first-page":"1001","article-title":"Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome","volume":"35","author":"Weiner","year":"1994"},{"key":"b67-0280002","series-title":"Int J Radiat Oncol Biol Phys","first-page":"17","article-title":"A comparison of the roles of surgery and radiation therapy in the management of craniopharyngiomas","volume":"16","author":"Wen","year":"1989"},{"key":"b68-0280002","series-title":"Stroke","first-page":"2243","article-title":"Improving the assessment of outcomes in stroke: use of a structured interview to assign grades on the modified Rankin Scale","volume":"33","author":"Wilson","year":"2002"},{"key":"b69-0280002","series-title":"J Neurotrauma","first-page":"573","article-title":"Structured interviews for the Glasgow Outcome Scale and the extended Glasgow Outcome Scale: guidelines for their use","volume":"15","author":"Wilson","year":"1998"},{"issue":"Suppl 1","key":"b70-0280002","series-title":"Pediatr Neurosurg","first-page":"108","article-title":"Surgical management of recurrent craniopharyngiomas","volume":"21","author":"Wisoff","year":"1994"},{"key":"b71-0280002","series-title":"Principles and Practice of Pediatric Neurosurgery","article-title":"Craniopharyngiomas","author":"Wisoff","year":"2008"},{"key":"b72-0280002","series-title":"J Neurosurg","first-page":"3","article-title":"Total removal of craniopharyngiomas. Approaches and long-term results in 144 patients","volume":"73","author":"Ya\u015fargil","year":"1990"},{"key":"b73-0280002","series-title":"Childs Nerv Syst","first-page":"679","article-title":"Radical resection of craniopharyngioma","volume":"21","author":"Zuccaro","year":"2005"},{"key":"b1-0280002","series-title":"Br J Cancer","first-page":"255","article-title":"Cognitive and academic outcome following cranial irradiation and chemotherapy in children: a longitudinal study","volume":"82","author":"Anderson","year":"2000"},{"key":"b2-0280002","series-title":"J Clin Exp Neuropsychol","first-page":"684","article-title":"Impairments of attention following treatment with cranial irradiation and chemotherapy in children","volume":"26","author":"Anderson","year":"2004"},{"key":"b3-0280002","series-title":"J Neurosurg","first-page":"547","article-title":"The descriptive epidemiology of craniopharyngioma","volume":"89","author":"Bunin","year":"1998"},{"key":"b4-0280002","series-title":"Childs 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