Management of Common Complications after Microsurgery for Craniopharyngioma

Objective To study the characteristics and treatment of the common complications after the resection of craniopharyngiomas.Methods The clinical data of 80 patients with craniopharyngiomas,who received surgical treatment in our department,were analyzed retrospectively.Results Of 72 patients suffering from diabetes insipidus after the microsurgery for craniopharyngiomas,39 were clinically recovered from diabetes insipidus and,33 had diabetes insipidus yet when they were discharged from hospital.Of 58 patients who had sodium disorders,31 patients suffered from hyponatremia,14 hypernatremia,and 13 sometimes hypernatremia and sometimes hyponatremia.Of 58 patients with sodium disorders,51 were cured and 7 had sodium disorders yet when being discharged from hospital.Hyperpyrexia occurred after the operation in 34 patients,whose body temperature became normal when they left hospital.Conscious disturbance occurred after the surgery in 20 patients,of whom,1 died of circulatory failure,11 regained consciousness and 8 had conscious disturbance yet when they left hospital.Epilepsy occurred after the surgery in 5 patients,of whom 1 died of epileptic state and 4 were cured.Conclusions Antidiuretic should be used reasonably to treat diabetes insipidus.Hyponatremia is caused by cerebral salt wasting syndrome(CSWS) or syndrome of inappropriate secretion of antidiuretic hormone(SIADH).CSWS should be treated by supplying sodium and water,and SIADH by diuresis and fluid restricting.Hypernatremia should be treated by restricting sodium,supplying water and antidiuretic.Hyperpyrexia should be controlled immediately.When patients have conscious disturbance,CT should be done to confirm whether hematoma or hydrocephalus occurred.In addition,the reason of conscious disturbance should be found from the electrolyte disturbances and use of cortical hormone.Epilepsy,which is a very dangerous complication after the resection of craniopharyngiomas,should be controlled immediately to avoid epileptic state.