Displacement of mammillary bodies by craniopharyngiomas involving the third ventricle: surgical-MRI correlation and use in topographical diagnosis

Clinical article

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Accurate diagnosis of the topographical relationships of craniopharyngiomas (CPs) involving the third ventricle and/or hypothalamus remains a challenging issue that critically influences the prediction of risks associated with their radical surgical removal. This study evaluates the diagnostic accuracy of MRI to define the precise topographical relationships between intraventricular CPs, the third ventricle, and the hypothalamus.


An extensive retrospective review of well-described CPs reported in the MRI era between 1990 and 2009 yielded 875 lesions largely or wholly involving the third ventricle. Craniopharyngiomas with midsagittal and coronal preoperative and postoperative MRI studies, in addition to detailed descriptions of clinical and surgical findings, were selected from this database (n = 130). The position of the CP and the morphological distortions caused by the tumor on the sella turcica, suprasellar cistern, optic chiasm, pituitary stalk, and third ventricle floor, including the infundibulum, tuber cinereum, and mammillary bodies (MBs), were analyzed on both preoperative and postoperative MRI studies. These changes were correlated with the definitive CP topography and type of third ventricle involvement by the lesion, as confirmed surgically.


The mammillary body angle (MBA) is the angle formed by the intersection of a plane tangential to the base of the MBs and a plane parallel to the floor of the fourth ventricle in midsagittal MRI studies. Measurement of the MBA represented a reliable neuroradiological sign that could be used to discriminate the type of intraventricular involvement by the CP in 83% of cases in this series (n = 109). An acute MBA (< 60°) was indicative of a primary tuberal-intraventricular topography, whereas an obtuse MBA (> 90°) denoted a primary suprasellar CP position, causing either an invagination of the third ventricle (pseudointraventricular lesion) or its invasion (secondarily intraventricular lesion; p < 0.01). A multivariate model including a combination of 5 variables (the MBA, position of the hypothalamus, presence of hydrocephalus, psychiatric symptoms, and patient age) allowed an accurate definition of the CP topography preoperatively in 74%–90% of lesions, depending on the specific type of relationship between the tumor and third ventricle.


The type of mammillary body displacement caused by CPs represents a valuable clue for ascertaining the topographical relationships between these lesions and the third ventricle on preoperative MRI studies. The MBA provides a useful sign to preoperatively differentiate a primary intraventricular CP originating at the infundibulotuberal area from a primary suprasellar CP, which either invaginated or secondarily invaded the third ventricle.

Abbreviations used in this paper:CP = craniopharyngioma; MB = mammillary body; MBA = mammillary body angle; TVF = third ventricle floor.

Article Information

Address correspondence to: José María Pascual, M.D., Ph.D., Department of Neurosurgery, La Princesa University Hospital, C/Diego de León 62, 28006 Madrid, Spain. email: jmpasncj@hotmail.com.

Please include this information when citing this paper: published online March 29, 2013; DOI: 10.3171/2013.1.JNS111722.

© AANS, except where prohibited by US copyright law.



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    Coronal MR images demonstrating the relative anatomical positions between the hypothalamus and different topographical categories of intraventricular CPs. The upper row (A1, B1, and C1) shows the relative anatomical position of the hypothalamus (arrows) with respect to 3 different topographical categories of intraventricular CPs as observed on images obtained at the level of the third ventricle. The lower row images (A2, B2, and C2) show examples of similar CP–hypothalamus relationships in 3 intraventricular lesions corresponding to the same topographical categories, as observed in whole brain autopsy specimens. A1 and A2: Strictly intraventricular CP of the squamous-papillary type. Both hypothalami (arrows) are positioned adjacent to the inferior or lower-third tumor portion in both images. From Zülch KJ: Atlas of Gross Neurosurgical Pathology, Springer-Verlag, 1975, pp 155–160. Reprinted with kind permission of Springer Science+Business Media. B1 and B2: Not strictly intraventricular CP of the adamantinomatous type. Both hypothalami (arrows and arrowheads) are positioned around the middle-third portion (equator) of the tumor in both images. Notice the wide, tight attachment of the tumor to the floor and walls of the third ventricle with a layer of gliosis interposed between the outer capsule and the viable hypothalamus. From Choux M, Lena G: Craniopharyngioma, in Apuzzo MLJ (ed): Surgery of the Third Ventricle, ed 2. Williams & Wilkins, 1998, pp 1143–118. Reprinted with permission from Wolters Kluwer. C1 and C2: Pseudointraventricular CP. Both hypothalami (arrows) are positioned over the upper-third portion of the tumor in both images. Note the anatomically intact TVF pushed against the roof of the third ventricle by the mass, which is mimicking a true intraventricular position.

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    This illustration shows the MBA (red lines) as it is measured on a midsagittal section of the brain. The MBA is the angle formed by the intersection of the plane tangential to the base of the MBs with the plane tangential to the floor of the fourth ventricle (IV ventricle floor). In normal circumstances, the MBA in both adults and children has an acute value ranging between 50° and 70° (unpublished results).

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    Assessment of the MBs on midsagittal MR images, showing MRI-pathological correlation in the 4 major topographical categories of third ventricle CPs. Displacement of the MBs and their positional changes after surgical excision of a CP are shown on preoperative and postoperative midsagittal MRIs, respectively, for the 4 topographical categories of intraventricular CPs. Similar midsagittal macroscopic sections of a whole CP autopsy specimen are shown for each topography in the far right column (A3, B3, C3, and D3). A1–A3: Images showing an example of a strictly intraventricular type of CP. The MBs are observed to be squeezed beneath the lesion on the preoperative MR image (A1, arrow). An intact TVF, including atrophied MBs, is identifiable on the postoperative MR image after complete surgical removal of the lesion through a translamina terminalis approach (A2, arrow). These figures were published in Surg Neurol 33, Fukushima T, Hirakawa K, Kimura M, Tomonaga M: Intraventricular craniopharyngioma: its characteristics in magnetic resonance imaging and successful total removal, pp. 22–27, Copyright Elsevier (1990). A similar displacement of the MBs can be observed in the autopsy specimen corresponding to a strictly intraventricular CP (A3, arrow). From Vogel FS, Fuller GN, Bouldin TW: The nervous system, in Rubin E, Farber JL (eds): Pathology, ed 3. Lippincott-Raven Publishers, 1999, pp. 1442–1535. Reprinted with permission from Wolters Kluwer. B1–B3: Images showing an example of a not strictly intraventricular type of CP. The MBs are observed beneath the lesion on the preoperative MR image (B1, arrow). A breached or defective TVF is observed after complete surgical removal of the lesion through a combined translamina terminalis-transcallosal approach; the MBs are the only identifiable structures of the TVF on the postoperative midsagittal MR image (B2, arrow). The displaced MBs can be observed in the autopsy specimen corresponding to a not strictly intraventricular CP replacing the infundibulotuberal area (B3, arrow). Reprinted with permission from Fung K-M, Oklahoma Department of Pathology, University of Oklahoma Health Science Center, Oklahoma City (http://moon.ouhsc.edu/kfung/JTY1/NeuroTest/Q24-Ans.htm). C1–C3: Images showing an example of a pseudointraventricular type of CP. The MBs are observed being pushed upon by the lesion on a preoperative MR image (C1, arrow). The MBs are identifiable in a normal position on the postoperative MR image after complete surgical removal of the lesion through a basal approach (C2, arrow). These figures were published in Mehta V, Black PM: Craniopharyngioma in the adult, in Winn HR (ed): Youmans Neurological Surgery, ed 5. Saunders, pp 1207–1221, Copyright Elsevier (2004). A similar displacement of the MBs can be observed in the autopsy specimen corresponding to a pseudointraventricular CP (C3, arrow). This figure was published in Currie AR, Wyllie AH: The pituitary gland, in Symmers WStC (ed): Systemic Pathology, ed 2. Churchill Livingstone, Vol 4, pp 1863–1912, Copyright Elsevier (1978). D1–D3: Images showing an example of a secondarily intraventricular type of CP. The MBs are observed on preoperative MRI beneath a lesion originating within the sellar compartment (D1, arrow). The MBs are identifiable in a normal position on postoperative MRI after complete surgical removal of the lesion through a basal and translamina terminalis approach (D2, arrow). Note the wide defect in the TVF and the normal pituitary gland. Reproduced with permission from Türe et al.: J Neurosurg 87:706–715, 1997. The MBs can be observed in the autopsy specimen corresponding to a secondarily intraventricular CP (D3, arrow). From Zülch KJ: Atlas of Gross Neurosurgical Pathology, Springer-Verlag, 1975, pp 155–160. Reprinted with kind permission of Springer Science+Business Media.

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    Bar graphs showing changes in the MBA associated with specific CP topographies. A: Graph showing the ranges in the mammillary angle value (MBA) measured for each CP's topographical category on preoperative midsagittal MR images. Note the opposite distribution of values between the pseudointraventricular topography, in which 90% of lesions showed MBA values greater than 90°, and the strict and not strict intraventricular topographies, both showing MBAs of less than 90° in all cases (p < 0.001, Pearson chi-square test). On average, the not strictly intraventricular category was associated with lower, or more acute, MBA values than the strictly intraventricular category. B: Graph demonstrating ranges in the MBA value measured postoperatively for each CP topography. Note the marked change in the ranges of MBA values shown postoperatively in each topographical category by comparing the distribution of bars between graphs A and B. Most of the obtuse (> 90°) MBA values measured preoperatively in the pseudointraventricular category have an acute value between 31° and 90° postoperatively, a change indicating a recovery in the position of the MBs after surgical removal of the tumor. In a similar way, the hyperacute (< 30°) MBA values measured preoperatively in the strict and not strict intraventricular categories are in the range of 31°–90° after surgical excision, indicating normalization in the anatomical position of the MBs. C: Graph showing types of changes in the MBA observed postoperatively for each CP topographical category. An acute type of change in the value of the MBA (from an MBA > 90° to one < 90°) characterizes the pseudointraventricular topography. The strict and not strict intraventricular categories show a similar relative proportion of obtuse changes (from a hyperacute MBA value to a less acute one) and no significant changes in the MBA (postoperative change < 10° in the MBA). However, the absolute change in the MBA was higher in the not strictly intraventricular category than in the strictly intraventricular category (p < 0.001, Pearson chi-square test). The secondarily intraventricular category showed the highest variability in the type of MBA change, with a similar number of cases undergoing an acute or obtuse modification of this value. No. = number of cases.

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    Data on MBA for discrimination of topographical categories of intraventricular CPs. A: Table showing mean (°), median (°), and SEM of the MBA values in each CP topography. B: Box plot comparing the preoperative MBA measured for each CP topography. A marked higher clustering of MBA values was measured in the pseudointraventricular topography. The infundibulotuberal, or not strictly intraventricular, category displayed the lowest mean and median MBA values, in accordance with the expansion of these lesions within the TVF causing the greatest backward displacement of the MBs. The highest dispersion of MBA values is observed in the secondarily intraventricular topography, in agreement with the multiplicity of points of origin of the lesion along the pituitary-hypothalamus axis. C: Table showing sensitivity and specificity values of the preoperative MBA calculated by regression logistic analysis for every pair of CP topographical categories. D: Table listing global classification results using the MBA. The absolute number of CPs correctly assigned to their topographical category and the rates of correct topographical diagnosis obtained with the use of the MBA are displayed. The pseudointraventricular topography is correctly discriminated in 94% of cases and the not strictly intraventricular topography in 67.5%. Not Strictly IV = not strictly intraventricular topography; Pseudo IV = pseudointraventricular topography; Secondary IV = secondarily intraventricular topography; Strictly IV = strictly intraventricular topography.

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    Multivariate model for discrimination of topographical categories of intraventricular CPs. A: Vectorial graph showing component loadings analysis after optimal scaling of neuroradiological variables. The neuroradiological (MRI) categorical variables considered in the study were transformed into ordinal variables by an optimal scaling process and each of the variables is represented in the graphic as a vector projected into a 2D space. The ordinal scaling is displayed for the topographical category vector (red), the mammillary angle (blue), and the hypothalamus position (brown). The angle between 2 pair of vectors is proportional to the degree of correlation of the variables represented by such vectors. The absolute values of the correlations between all the transformed neuroradiological variables after optimal scaling and the CP topography are shown in the list below the vectorial graphic. The 2 variables showing the highest negative correlations with the CP topographical categories considered were the preoperative MBA value (blue vector) and the relative anatomical position of the hypothalamus (brown vector). This negative correlation indicates that a higher MBA value and an upper hypothalamus position (values at the end of their respective vectors) are correlated with the pseudointraventricular topography (the first position in the CP topography vector). In contrast, a lower MBA value and a lower hypothalamus position are correlated with the strictly intraventricular category. B: Scatter plot representing the topographical differentiation of the CPs in a 2D space defined by the discriminant coefficients of 5 variables selected in a stepwise discriminant analysis. Topographical categories were optimally discriminated with a model of 5 variables selected from the pool of variables analyzed in the study through a process of stepwise discriminant analysis. These 5 variables were the preoperative MBA, the relative position of the hypothalamus, the presence of hydrocephalus, the presence of psychiatric symptoms, and patient age. The canonical discriminant coefficients calculated for these variables are shown below the figure. The groups of pseudointraventricular and secondarily intraventricular CPs can be discriminated from the strictly and not strictly intraventricular topographies on dimension 1 (factor 1) by their higher (more positive) MBA values and the upper (more positive) hypothalamus level. The strictly intraventricular category is best discriminated from the not strictly intraventricular topography on dimension 2 (factor 2) by a higher rate of psychiatric symptoms (more positive), hydrocephalus, and an older patient age.

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    Illustrations showing changes in the MBA caused by progression of intraventricular CPs, including differential effects of specific CP topographies. a1–a4: Midsagittal brain section showing the backward displacement of the MBs caused by the growth of an intraventricular CP that originated at the infundibulotuberal area of the TVF (infundibulotuberal or not strictly intraventricular CP). The value of the MBA (red lines) undergoes a progressive decrease (more acute MBA) as the tumor mass expands in the third ventricle until the MBs become compressed against the midbrain. b1–b4: Similar illustrations showing the opposite change in the MBA caused by a primary suprasellar lesion that pushes the TVF upward, mimicking a third ventricle position (pseudointraventricular CP). The value of the MBA (red lines) undergoes a progressive increase (more obtuse MBA) as the tumor mass folds inwards into the TVF until the MBs become compressed against the fornices and roof of the third ventricle.



Al-Mefty OAyoubi SKadri PAS: The petrosal approach for the total renoval of giant retrochiasmatic craniopharyngiomas in children. J Neurosurg (2 Suppl Pediatrics) 106:87922007


Alén JFBoto GRLagares Ade la Lama AGómez PALobato RD: Intratumoural bleomycin as a treatment for recurrent cystic craniopharyngioma. Case report and review of the literature. Neurocirugia (Astur) 13:4794852002


Alexander TDWeir BKAWhat is the best treatment for craniopharyngiomas involving the third ventricle?. Apuzzo MLJ: Surgery of the Third Ventricle ed 2BaltimoreWilliams & Wilkins1998. 11831191


Bae JSYang SHJeun SSPark CKKang JKHong YK: Experiences of bifrontal interhemispheric approach in craniopharyngioma surgery. J Korean Neurosurg Soc 40:6102006


Bailey P: Concerning the cerebellar symptoms produced by suprasellar tumors. Arch Neurol Psych 11:1371501924


Barajas MARamírez-Guzmán GRodríguez-Vázquez CToledo-Buenrostro VVelásquez-Santana Hdel Robles RV: Multimodal management of craniopharyngiomas: neuroendoscopy, microsurgery, and radiosurgery. J Neurosurg 97:5 Suppl6076092002


Bauer BLHellwig DSweet WHSchmidek HHSurgical management of intracranial arachnoid, suprasellar, and Rathke's cleft cysts. Schmidek HHSweet WH: Operative Neurosurgical Techniques Indications Methods and Results ed 3PhiladelphiaWB Saunders1995. 579614


Bunin GRSurawicz TSWitman PAPreston-Martin SDavis FBruner JM: The descriptive epidemiology of craniopharyngioma. J Neurosurg 89:5475511998


Caceres AReitman AJTomita T: Craniopharyngioma and Cushing disease. Case report. J Neurosurg 3 Suppl102:3183212005


Caemaert JEndoscopic neurosurgery. Schmideck HH: Operative Neurosurgical Techniques: Indications Methods and Results ed 4PhiladelphiaWB Saunders2000. 1:535570


Cantore GEsposito VFraioli BSurgical treatment of craniopharyngiomas. Broggi G: Craniopharyngioma: Surgical Treatment MilanoSpringer-Verlag1995. 104112


Carvi y Nievas MNSchneider HHöllerhage HGHaas E: Minimal invasive neurosurgery of infiltrative tumours extending around the sellar region: advantage of combined methods. Minim Invasive Neurosurg 46:2842882003


Chen HJ: The neurological abnormalities and operative findings in the transcallosal approach for large juxtasellar-ventricular craniopharyngiomas. J Clin Neurosci 9:1591632002


Chen TCKrieger MHinton DRZee CSApuzzo MLJThe colloid cyst. Apuzzo MLJ: Surgery of the Third Ventricle 2 edBaltimoreWilliams & Wilkins1998. 10711132


Cheng WYChang CSShen CCWang YCSun MHHsieh PP: Endoscope-assisted microsurgery for treatment of a suprasellar craniopharyngioma presenting precocious puberty. Pediatr Neurosurg 34:2472512001


Choux MLena GCraniopharyngioma. Apuzzo MLJ: Surgery of the Third Ventricle ed 2BaltimoreWilliams & Wilkins1998. 11431181


Choux MLena GGenitori L: [Craniopharyngioma in children.]. Neurochirurgie 37:Suppl 1591001991. (Fr)


Chung WYPan HCGuo WYShiau CYWang LWWu HM: Protection of visual pathway in gamma knife radiosurgery for craniopharyngiomas. Stereotact Funct Neurosurg 70:Suppl 11391511998


Cinalli GSpennato PCianciulli EFiorillo ADi Maio SMaggi G: The role of transventricular neuroendoscopy in the management of craniopharyngiomas: three patient reports and review of the literature. J Pediatr Endocrinol Metab 19:Suppl 13413542006


Crotty TBScheithauer BWYoung WF JrDavis DHShaw EGMiller GM: Papillary craniopharyngioma: a clinicopathological study of 48 cases. J Neurosurg 83:2062141995


Currie ARWyllie AHThe pituitary gland. Symmers WStC: Systemic Pathology ed 2EdinburghChurchill Livingstone1978. 4:18631912


de Divitiis ECappabianca PCavallo LMEsposito Fde Divitiis OMessina A: Extended endoscopic transsphenoidal approach for extrasellar craniopharyngiomas. Neurosurgery 61:5 Suppl 22192282007


de Vile CJGrant DBHayward RDKendall BENeville BGStanhope R: Obesity in childhood craniopharyngioma: relation to post-operative hypothalamic damage shown by magnetic resonance imaging. J Clin Endocrinol Metab 81:273427371996


De Vile CJGrant DBKendall BENeville BGRStanhope RWatkins KE: Management of childhood craniopharyngioma: can the morbidity of radical surgery be predicted?. J Neurosurg 85:73811996


Dhellemmes PVinchon M: Radical resection for craniopharyngiomas in children: surgical technique and clinical results. J Pediatr Endocrinol Metab 19:1 Suppl 13293352006


Dolenc VV: Microsurgical Anatomy and Surgery of the Central Skull Base WienSpringer-Verlag2003. 289298


Dolenc VVSkull and skull base tumors: overview. Winn HR: Youmans Neurological Surgery 5 edPhiladelphiaSaunders2004. 12611285


Dott NMSurgical aspects of the hypothalamus. Le Gros Clarke WEBeattie JRiddoch G: The Hypothalamus. Morphological Functional Clinical and Surgical Aspects EdinburghOliver & Boyd1938. 131199


Dusick JREsposito FKelly DFCohan PDeSalles ABecker DP: The extended direct endonasal transsphenoidal approach for nonadenomatous suprasellar tumors. J Neurosurg 102:8328412005


Einhaus SLSanford RACraniopharyngiomas. Albright ALPollack IFAdelson PD: Principles and Practice of Pediatric Neurosurgery New YorkThieme Medical Publishers1999. 545562


Erdheim J: Über Hypophysengangsgeschwulste und Hirmcholesteatome. Sitzungsb Kais Akad Wissen Math Naturw Klin 113:5377261904


Fahlbusch RHonegger JBuchfelder MClinical features and management of craniopharyngiomas in adults. Tindall GTCooper PRBarrow DL: The Practice of Neurosurgery BaltimoreWilliams & Wilkins1996. 1:11591173


Fahlbusch RHonegger JPaulus WHuk WBuchfelder M: Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 90:2372501999


Fraioli MFSantoni RFraioli CContratti F: “Conservative” surgical approach and early postoperative radiotherapy in a patient with a huge cystic craniopharyngioma. Childs Nerv Syst 22:1511552006


Frank GPasquini EDoglietto FMazzatenta DSciarretta VFarneti GCalbucci F: The endoscopic extended transsphenoidal approach for craniopharyngiomas. Neurosurgery 59:1 Suppl 1ONS75ONS832006


Freitag SKMiller NRBrem H: Recurrent ectopic craniopharyngioma. Br J Neurosurg 15:5115132001


Fujitsu KSekino TSakata KKawasaki T: Basal interfalcine approach through a frontal sinusotomy with vein and nerve preservation. Technical note. J Neurosurg 80:5755791994


Fukushima THirakawa KKimura MTomonaga M: Intraventricular craniopharyngioma: its characteristics in magnetic resonance imaging and successful total removal. Surg Neurol 33:22271990


Fung KM: NeuroTest sample question #24 University of Oklahoma Health Sciences Center(http://moon.ouhsc.edu/kfung/JTY1/NeuroTest/Q24-Ans.htm) [Accessed January 14 2013]


Gardner PAKassam ABSnyderman CHCarrau RLMintz AHGrahovac S: Outcomes following endoscopic, expanded endonasal resection of suprasellar craniopharyngiomas: a case series. J Neurosurg 109:6162008


Gifi A: Nonlinear Multivariate Analysis New YorkJohn Wiley & Sons1991


Harrison MJMorgello SPost KD: Epithelial cystic lesions of the sellar and parasellar region: a continuum of ectodermal derivatives?. J Neurosurg 80:101810251994


Honegger JBarocka ASadri BFahlbusch R: Neuropsychological results of craniopharyngioma surgery in adults: a prospective study. Surg Neurol 50:19291998


Honegger JGrabenbauer GGPaulus WFahlbusch R: Regression of a large solid papillary craniopharyngioma following fractionated external radiotherapy. J Neurooncol 41:2612661999


Ikezaki KFujii KKishikawa T: Magnetic resonance imaging of an intraventricular craniopharyngioma. Neuroradiology 32:2472491990


Inoue HKFujimaki HKohga HOno NHirato MOhye C: Basal interhemispheric supra- and/or infrachiasmal approaches via superomedial orbitotomy for hypothalamic lesions: preservation of hypothalamo-pituitary functions in combination treatment with radiosurgery. Childs Nerv Syst 13:2502561997


Jho HD: The expanding role of endoscopy in skull-base surgery. Indications and instruments. Clin Neurosurg 48:2873052001


Kadri HMawla AA: Endoscopy-assisted microsurgical total resection of craniopharyngioma in childhood. Minim Invasive Neurosurg 49:3693722006


Kamikawa SInui A: Pediatric malignancies. Case 3 Craniopharyngioma in a 4-year-old girl: neuroendoscopic diagnosis and treatment. J Clin Oncol 23:479347942005


Kang JKLee KSLee TKJeun SSHong YKKim MC: Role of bifrontal basal interhemispheric approach in recurrent suprasellar tumors; craniopharyngioma and pituitary tumors. Int Congr Ser 1259:1191272004


Kapur NCrewes HWise RAbbott PCarter MMilar J: Mammillary body damage results in memory impairment but not amnesia. Neurocase 4:5095171998


Kassam ABGardner PASnyderman CHCarrau RLMintz AHPrevedello DM: Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum. J Neurosurg 108:7157282008


Kelly DF: Craniopharyngioma. Endonasal Endoscopic & Keyhole Surgery (http://www.youtube.com/watch?v=lYU6uX_R2dA) [Accessed January 16 2013]


Kitano MTaneda M: Extended transsphenoidal surgery for suprasellar craniopharyngiomas: infrachiasmatic radical resection combined with or without a suprachiasmatic translamina terminalis approach. Surg Neurol 71:2902982009


Kobayashi TKageyama NYoshida JShibuya NYonezawa T: Pathological and clinical basis of the indications for treatment of craniopharyngiomas. Neurol Med Chir (Tokyo) 21:39471981


Kobayashi TTanaka TKida Y: Stereotactic gamma radiosurgery of craniopharyngiomas. Pediatr Neurosurg 21:Suppl 169741994


Kornienko VNPronin IN: Diagnostic Neuroradiology BerlinSpringer-Verlag2009. 558573


Kouri JGChen MYWatson JCOldfield EH: Resection of suprasellar tumors by using a modified transsphenoidal approach. Report of four cases. J Neurosurg 92:102810352000


Kupers RCFortin AAstrup JGjedde APtito M: Recovery of anterograde amnesia in a case of craniopharyngioma. Arch Neurol 61:194819522004


Kuramoto TUchikado HTajima YTokutomi TShigemori M: [Neuroendoscopic placement of the reservoir in an elderly patient with recurrenced craniopharyngioma: case report.]. No Shinkei Geka 33:120712122005. (Jpn)


Lan QDong JHuang Q: Minimally invasive keyhole approaches for removal of tumors of the third ventricle. Chin Med J (Engl) 119:144414502006


Laufer IAnand VKSchwartz TH: Endoscopic, endonasal extended transsphenoidal, transplanum transtuberculum approach for resection of suprasellar lesions. J Neurosurg 106:4004062007


Lejeune JPLe Gars DHaddad E: [Tumors of the third ventricle: review of 262 cases.]. Neurochirurgie 46:2112382000. (Fr)


Lena GPaz Paredes AScavarda DGiusiano B: Craniopharyngioma in children: Marseille experience. Childs Nerv Syst 21:7787842005


Maira GAnile CAlbanese ACabezas DPardi FVignati A: The role of transsphenoidal surgery in the treatment of craniopharyngiomas. J Neurosurg 100:4454512004


Maira GAnile CColosimo CCabezas D: Craniopharyngiomas of the third ventricle: trans-lamina terminalis approach. Neurosurgery 47:8578652000


Maira GAnile CRossi GFColosimo C: Surgical treatment of craniopharyngiomas: an evaluation of the transsphenoidal and pterional approaches. Neurosurgery 36:7157241995


Mehta VBlack PMCraniopharyngioma in the adult. Winn HR: Youmans Neurological Surgery ed 5PhiladelphiaSaunders2004. 12071221


Meuric SBrauner RTrivin CSouberbielle JCZerah MSainte-Rose C: Influence of tumor location on the presentation and evolution of craniopharyngiomas. J Neurosurg 5 Suppl103:4214262005


Miyoshi YYunoki MYano ANishimoto K: Diencephalic syndrome of emaciation in an adult associated with a third ventricle intrinsic craniopharyngioma: case report. Neurosurgery 52:2242272003


Mooj JJAGo KGCysts, cyst-like tumors and other maldevelopmental tumors. Vinken PJBruyn GWVecht CJ: Handbook of Clinical Neurology. Neuro-Oncolog Part II: Gliomas and Other Primary Tumors of the Brain and Spinal Cord AmsterdanElsevier Science1997. 68:309342


Morita AKelly PJ: Resection of intraventricular tumors via a computer-assisted volumetric stereotactic approach. Neurosurgery 32:9209271993


Myseros JSReigel DHIntraventricular tumors. McLone DG: Pediatric Neurosurgery: Surgery of the Developing Nervous System ed 4PhiladelphiaWB Saunders2001. 755766


Nakamizo AInamura TNishio SInoha SIshibashi HFukui M: Neuroendoscopic treatment of cystic craniopharyngioma in the third ventricle. Minim Invasive Neurosurg 44:85872001


Nicolato AForoni RRosta LGerosa MBricolo A: Multimodality stereotactic approach to the treatment of cystic craniopharyngiomas. Minim Invasive Neurosurg 47:32402004


Nimsky CGanslandt OHofmann BFahlbusch R: Limited benefit of intraoperative low-field magnetic resonance imaging in craniopharyngioma surgery. Neurosurgery 53:72812003


Nishizawa SOhta SOki Y: Spontaneous resolution of diabetes insipidus after pituitary stalk sectioning during surgery for large craniopharyngioma. Endocrinological evaluation and clinical implications for surgical strategy. Neurol Med Chir (Tokyo) 46:1261352006


Nomura HKurimoto MNagai SHayashi NHirashima YTsukamoto E: Multiple intracranial seeding of craniopharyngioma after repeated surgery—case report. Neurol Med Chir (Tokyo) 42:2682712002


Northfield DWC: Rathkepouch tumours. Brain 80:2933121957


Novegno FDi Rocco FColosimo C JrLauriola LCaldarelli M: Ectopic recurrences of craniopharyngioma. Childs Nerv Syst 18:4684732002


Ohata KTakami TGoto THara M: Surgical removal of retrochiasmatic craniopharyngiomas with transpetrosal approach. Op Tech Neurosurg 6:2002042003


Oi SSamii ASamii M: Operative techniques for tumors in the third ventricle. Op Tech Neurosurg 6:2052142003


Pan JQi SLu YFan JZhang XZhou J: Intraventricular craniopharyngioma: morphological analysis and outcome evaluation of 17 cases. Acta Neurochir (Wien) 153:7737842011


Pascual JMCarrasco RPrieto RGonzalez-Llanos FAlvarez FRoda JM: Craniopharyngioma classification. J Neurosurg 109:118011832008. (Letter)


Pascual JMGonzález-Llanos FBarrios LRoda JM: Intraventricular craniopharyngiomas: topographical classification and surgical approach selection based on an extensive overview. Acta Neurochir (Wien) 146:7858022004


Pascual JMPrieto RCarrasco R: Craniopharyngiomas involving the floor of the third ventricle. Acta Neurochir (Wien) 152:244724522011. (Letter)


Pascual JMPrieto RCarrasco R: Infundibulo-tuberal or not strictly intraventricular craniopharyngioma: evidence for a major topographical category. Acta Neurochir (Wien) 153:240324252011


Pascual JMPrieto RNavas MCarrasco R: Conquest of third ventricle craniopharyngiomas. J Neurosurg 112:115611612010. (Letter)


Pierre-Kahn ARecassens CPinto GThalassinos CChokron SSoubervielle JC: Social and psycho-intellectual outcome following radical removal of craniopharyngiomas in childhood. A prospective series. Childs Nerv Syst 21:8178242005


Prasad DSteiner MSteiner L: Gamma knife surgery for craniopharyngioma. Acta Neurochir (Wien) 134:1671761995


Provenzale JMTaveras JM: Clinical Cases in Neuroradiology Malvern, PALea & Febiger1994. 264270


Puget SGarnett MWray AGrill JHabrand JLBodaert N: Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg 1 Suppl106:3122007


Qi SLu YPan JZhang XLong HFan J: Anatomic relations of the arachnoidea around the pituitary stalk: relevance for surgical removal of craniopharyngiomas. Acta Neurochir (Wien) 153:7857962011


Raybaud CRabehanta PGirard N: Aspects radiologiques des craniopharyngiomas. Neurochirurgie 37:1 Suppl44581991


Rencher AC: Interpretation of canonical discriminant functions, canonical variables, and principal components. Am Stat 46:2172251992


Rilliet BVernet OPica A: The Geneva and Lausanne (French-speaking Switzerland) experience: in favor of the transsphenoidal approach when feasible. Childs Nerv Syst 21:7257282005


Rushing EJGiangaspero FPaulus WBurger PCCraniopharyngioma. Louis DNOhgaki HWiestler OD: WHO Classification of Tumours of the Central Nervous System ed 4LyonIARC Press2007. 238240


Saeki NMurai HKubota MFujimoto NIuchi TYamaura A: Heavily T2 weighted MR images of anterior optic pathways in patients with sellar and parasellar tumours - prediction of surgical anatomy. Acta Neurochir (Wien) 144:25352002


Sainte-Rose CPuget SWray AZerah MGrill JBrauner R: Craniopharyngioma: the pendulum of surgical management. Childs Nerv Syst 21:6916952005


Sartoretti-Schefer SWichmann WAguzzi AValavanis A: MR differentiation of adamantinous and squamous-papillary craniopharyngiomas. AJNR Am J Neuroradiol 18:77871997


Shi XEWu BZhou ZQFan TZhang YL: Microsurgical treatment of craniopharyngiomas: report of 284 patients. Chin Med J (Engl) 119:165316632006


Shibuya MTakayasu MSuzuki YSaito KSugita K: Bifrontal basal interhemispheric approach to craniopharyngioma resection with or without division of the anterior communicating artery. J Neurosurg 84:9519561996


Shirane RSu CCKusaka YJokura HYoshimoto T: Surgery for craniopharyngiomas extending outside the suprasellar cistern. Int Congr Ser 1247:2472632002


Sipos LVajda J: Craniopharyngioma of the third ventricle. Acta Neurochir (Wien) 139:92931997


Spaziante Rde Divitiis E: Drainage techniques for cystic craniopharyngiomas. Neurosurg Q 7:1832081997


Srinivasan JDailey ATBerger MS: The bifrontal olfactory nerve-sparing approach to lesions of the suprasellar region in children. Pediatr Neurosurg 30:2452521999


Steiner LPrasad DLindquist CKarlsson BSteiner MGamma knife surgery in vascular, neoplastic, and functional disorders of the nervous system. Schmidek HHSweet WH: Operative Neurosurgical Techniques Indications Methods and Results ed 3PhiladelphiaWB Saunders1995. 667694


Steno J: Microsurgical topography of craniopharyngiomas. Acta Neurochir Suppl (Wien) 35:941001985


Steno JMalácek MBízik I: Tumor-third ventricular relationships in supradiaphragmatic craniopharyngiomas: correlation of morphological, magnetic resonance imaging, and operative findings. Neurosurgery 54:105110602004


Swaab DFCorpora mamillaria. Aminoff MJBoller FSwaab DF: Handbook of Clinical Neurology. The Human Hypothalamus: Basic and Clinical Aspects. Part I: Nuclei of the Human Hpypothalamus AmsterdamElsevier2003. 79:291295


Takahashi TKudo KIto SSuzuki S: Spontaneously ruptured craniopharyngioma cyst without meningitic symptoms— two case reports. Neurol Med Chir (Tokyo) 43:1501522003


Tanaka YMiyazawa YAkaoka FYamada T: Amnesia following damage to the mammillary bodies. Neurology 48:1601651997


Tomita TBowman RM: Craniopharyngiomas in children: surgical experience at Children's Memorial Hospital. Childs Nerv Syst 21:7297462005


Türe UYaşargil MGAl-Mefty O: The transcallosal-transforaminal approach to the third ventricle with regard to the venous variations in this region. J Neurosurg 87:7067151997


Van Gompel JJNippoldt TBHiggins DMMeyer FB: Magnetic resonance imaging-graded hypothalamic compression in surgically treated adult craniopharyngiomas determining postoperative obesity. Neurosurg Focus 28:4E32010


Vann SDAggleton JP: The mammillary bodies: two memory systems in one?. Nat Rev Neurosci 5:35442004


Vogel FSFuller GNBouldin TWThe nervous system. Rubin EFarber JL: Pathology ed 3PhiladelphiaLippincott-Raven Publishers1999. 14421535


Williams MPennybacker J: Memory disturbances in third ventricle tumours. J Neurol Neurosurg Psychiatry 17:1151231954


Xie TZhang XBYun HHu FYu YGu Y: 3D-FIESTA MR images are useful in the evaluation of the endoscopic expanded endonasal approach for midline skull-base lesions. Acta Neurochir (Wien) 153:12182011


Yaşargil MG: Craniopharyngioma. Microneurosurgery StuttgartGeorg Thieme Verlag1996. IV-B:205223


Yaşargil MGAbdulrauf SI: Surgery of intraventricular tumors. Neurosurgery 62:6 Suppl 3102910412008


Yaşargil MG: Microneurosurgery StuttgartGeorg Thieme Verlag1994. IV-A:202211


Yasumoto YIto M: Asymptomatic spontaneous rupture of craniopharyngioma cyst. J Clin Neurosci 15:6036062008


Zada GLin NOjerholm ERamkissoon SLaws ER: Craniopharyngioma and other cystic epithelial lesions of the sellar region: a review of clinical, imaging, and histopathological relationships. Neurosurg Focus 28:4E42010


Zamorano LViñas FCJiang ZDiaz FG: Use of surgical wands in neurosurgery. Adv Tech Stand Neurosurg 24:771281998


Zhang YDChen ZSong YQLiu CChen YP: Making a tooth: growth factors, transcription factors, and stem cells. Cell Res 15:3013162005


Zuccaro G: Radical resection of craniopharyngioma. Childs Nerv Syst 21:6796902005


Zülch KJ: Atlas of Gross Neurosurgical Pathology New YorkSpringer-Verlag1975. 155160


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