title: Multimodal management of craniopharyngiomas: neuroendoscopy, microsurgery, and radiosurgery.
abstract: OBJECTIVE
  The goal of this study was to examine the role of gamma knife radiosurgery (GKS) and adjuvant neuroendoscopic procedures by assessing the outcome in 10 patients with craniopharyngiomas who were treated between 1998 and 2001.
  
  
  METHODS
  In 10 consecutive patients (six males and four females, mean age 12 years [range 7-32 years]), there were nine mixed and one solid craniopharyngioma. In the last three cases, neuroendoscopic procedures were conducted. Two cases required insertion of an Ommaya reservoir. In another case partial removal of the cyst wall was performed using an endoscope to create a communication with the cerebrospinal pathways and thereby preclude the need for shunt insertion.
  
  
  CONCLUSIONS
  Multimodal management of craniopharyngiomas seems to provide a better rate of survival and greater long-term disease control. It is suggested that GKS combined with adjuvant neuroendoscopy should be used as an alternative in treating recurrent or residual craniopharyngiomas if additional microsurgical removal cannot guarantee a cure.
authors.affiliation: Neurosciences Division, Gamma Knife Unit, Department of Neuroradiology, Hospital San Javier, Guadalajara, Jalisco, México.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Barajas
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Ramírez-Guzmán
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodríguez-Vázquez
authors.forename: Vinicio
authors.initials: V
authors.lastname: Toledo-Buenrostro
authors.forename: Héctor
authors.initials: H
authors.lastname: Velásquez-Santana
authors.forename: Ramiro Valle
authors.initials: RV
authors.lastname: del Robles
authors.forename: Abel
authors.initials: A
authors.lastname: Cuevas-Solórzano
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rodríguez-Hernández
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003397:Craniopharyngioma / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D009493:Neurosurgery; D010911:Pituitary Neoplasms / Q000601:surgery*; D016634:Radiosurgery; D016896:Treatment Outcome