Management of hypothalamic disease in patients with craniopharyngioma

Thompson, Christopher J.; Costello, Richard W.; Crowley, Rachel

doi:10.1111/cen.13929

Cited by 30 publications

(24 citation statements)

References 119 publications

(180 reference statements)

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“…This is in keeping with previous studies reporting that children and adolescents with CP complain of somnolence, fatigue, and sleep-wake disruption, which persist in 65-80% of the cases after treatment (20,31). Similar data were reported in unselected adults with CP, with a prevalence of SDs around 70% (10). Of note, EDS may reduce work/education performance in 43% of patients with CP (6).…”

Section: Classification and Pathogenesis Of Sleep Disorders In Patien...supporting

confidence: 90%

Sleep Disorders in Patients With Craniopharyngioma: A Physiopathological and Practical Update

et al. 2022

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Sleep disorders (SDs) represent an important issue in patients with craniopharyngioma (CP). Nearly 70% of these patients complain of sleep-wake cycle alterations and/or excessive diurnal somnolence due to sleep-related breathing disorders, such as obstructive sleep apnea (OSA) and/or central hypersomnia, including secondary narcolepsy. SDs may severely reduce quality of life, increase disease-related cardiorespiratory and cardiovascular morbidity, and finally play a major role in increased long-term mortality reported on patients with CP. A major risk factor for SDs is represented by the hypothalamic syndrome, which may develop because of direct hypothalamic damage by the tumor itself and/or complications of the treatments, neurosurgery and/or radiotherapy, and typically includes permanent neuroendocrine dysfunctions, morbid obesity, and secondary metabolic disorders. Despite increasing attention to SDs in the general population, and in particular to OSA as a risk factor for cardio-metabolic diseases and excessive daytime somnolence, sleep evaluation is still not routinely proposed to patients with CP. Hence, SDs are often underdiagnosed and undertreated. The aim of this paper is to update current knowledge of the pathogenesis and prevalence of SDs in patients with CP and propose practical algorithms for their evaluation and management in clinical practice. Particular attention is paid to screening and diagnostic tools for appropriate characterization of SDs, identification of risk factors, and potential role of hypothalamic sparing surgery in the prevention of morbid obesity and SDs. Available tools in sleep medicine, including lifestyle interventions, drugs, and respiratory devices, are discussed, as well as the importance of optimal hormone replacement and metabolic interventions. Current limits in the diagnosis and treatment of SDs in patients with CP and possible future avenues for research agenda are also considered.

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Section: Classification and Pathogenesis Of Sleep Disorders In Patien...supporting

confidence: 90%

Sleep Disorders in Patients With Craniopharyngioma: A Physiopathological and Practical Update

et al. 2022

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“…Following surgery for craniopharyngiomas, permanent diabetes insipidus is observed in up to 80% of patients. 3,46 Diabetes insipidus can serve as a marker for hypothalamic damage, and obesity in these patients is frequently observed. Diagnosis is made by increased urine output (higher than 3 L/day) with inappropriately high serum sodium and plasma osmolality levels and low concomitant urinary osmolality following a certain period of fluid restriction.…”

Section: Antidiuretic Hormone Deficiency (Central Diabetes Insipidus)mentioning

confidence: 99%

Diagnosis and Management of Neuroendocrine Disorders of Survivors of Brain Tumors

Erickson

Donegan

2021

American Society of Clinical Oncology Educational Book

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Advances in the treatment of brain tumors have led to an increase in the number of survivors of this disease. Consequently, the long-term complications associated with past and current treatments are becoming more apparent. Of relevance to patients who receive treatment of brain tumors are the potential neuroendocrine complications that develop either acutely or several years following treatment. Presentation may differ between adults and children (e.g., short stature or adult growth hormone deficiency) but in both settings can complicate treatment and impact quality of life. The risk for the development of these complications depends on the location of the tumor (proximity to the pituitary/hypothalamus) and/or the treatment delivered (chemotherapy/surgery/radiation). Given the potential overlap in symptoms attributable to the underlying brain tumor and neuroendocrine dysfunction, a high level of suspicion, appropriate investigation, and administration of treatment may reduce morbidity and mortality for patients with brain tumors experiencing neuroendocrine dysfunction.

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“…In a non-stressed state, signs and symptoms of adrenal insufficiency may be so subtle that they are not recognized, but they may alternatively include anorexia, nausea, shakiness relieved by eating, hypoglycemia, poor weight gain, poor stamina, or easy fatigability ( 66 ). Patients with craniopharyngioma is often identified by symptomatic hyponatremia secondary to ACTH deficiency ( 67 ). Adrenocortical dysfunction may greatly impact the rehabilitation of patients, and the hormone replacement therapy is a key step in craniopharyngioma treatment ( 68 ).…”

Section: Pituitary Hormone Deficiencymentioning

confidence: 99%

Endocrine Disorder in Patients With Craniopharyngioma

Zhou

Zhang

2021

Front. Neurol.

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Craniopharyngioma is an intracranial congenital epithelial tumor growing along the pathway of the embryonic craniopharyngeal tube. The main clinical symptoms of patients with craniopharyngioma include high intracranial pressure, visual field defect, endocrine dysfunction, and hypothalamic dysfunction. At present, the preferred treatment remains the surgical treatment, but the recovery of endocrine and hypothalamic function following surgery is limited. In addition, endocrine disorders often emerge following surgery, which seriously reduces the quality of life of patients after operation. So far, research on craniopharyngioma focuses on ways to ameliorate endocrine dysfunction. This article reviews the latest research progress on pathogenesis, manifestation, significance, and treatment of endocrine disorders in patients with craniopharyngioma.

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Management of hypothalamic disease in patients with craniopharyngioma

Cited by 30 publications

References 119 publications

Sleep Disorders in Patients With Craniopharyngioma: A Physiopathological and Practical Update

Sleep Disorders in Patients With Craniopharyngioma: A Physiopathological and Practical Update

Diagnosis and Management of Neuroendocrine Disorders of Survivors of Brain Tumors

Endocrine Disorder in Patients With Craniopharyngioma

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