Haemorrhagic Presentation of a Craniopharyngioma in a Pregnant Woman

Table 1

Case reports of haemorrhages in craniopharyngiomas.

Author, year	Age, sex of patient	Previous clinical history	Symptoms of presentation	Type of haemorrhage	Hospital course	Histology	Follow-up
Gass, 1956 [7]	<1 yr			Bilateral SDH
Lloyd and Belchetz, 1977 [8]	29 yrs, F	Secondary amenorrhea and frequent HAs for a few months	HA, vomiting, fever, drowsiness, neck rigidity, right temporal field defect, and hypopituitarism	Intratumoral	1st craniotomy: partial resection, irradiation of the pituitary fossa, hormone replacement, and 2nd reintervention		30 mths later: persistent right temporal field defect, hormone replacement-dependent
Kubota et al., 1980 [9]	>29 yrs			SAH
Wakai et al., 1982 [10]	>15 yrs
Kellen et al., 1988 [11]	37 yrs, M	Minor head injury in a car accident	Diplopia	“Secondary” intratumoral		Sq
Yamamoto et al., 1989 [12]	59 yrs, F	Sciatic pain and mild HA for two months previously	HA, nausea	Intratumoral	Right F-T craniotomy: subtotal resection	Ad	Transient DI
Masuda et al., 1990 [13]	63 yrs, F		Bitemporal hemianopsia, late visual symptoms	Intratumoral	1st transsphenoidal removal of hematoma; other 3 operations: partial resection	Sq	Recurrence, enlargement and histological modification of the tumor
Yousem et al., 1990 [14]	1–23 yrs			Intratumoral
Yousem et al., 1990 [14]	16 mths		Visual disturbances	Intratumoral
Makwane et al., 1996 [15]	46 yrs, M		HA, vomiting	Intratumoral
Ishii et al., 1999 [16]	44 yrs, F		HA, bitemporal hemianopsia, hypopituitarism, and DI	Intratumoral	Transsphenoidal partial resection	Sq
Nishioka et al., 2000 [17]	49 yrs, F	22 yrs previously right F-T craniotomy, partial resection, and residual right visual defect	HA, nausea, anorexia, hypopituitarism, and left visual disturbance	Intratumoral	Hormone replacement, transsphenoidal complete resection	Sq	Left visual function improved immediately after surgery
Yamashita et al., 2004 [18]	22 yrs, M		Declining vision and bitemporal hemianopsia after two lumbar taps, mild DI	Intratumoral	DDAVP, craniotomy with total resection of the tumour and haemorrhage	Sq	Vision returned to normal, hormone replacement
Yamashita et al., 2004 [18]	29 yrs, F	1st transsphenoidal suprasellar resection (vision normalized after surgery)	HA and bitemporal hemianopsia a few months after 1st operation	Intraresidual of the lesion	Craniotomy with partial resection of the haemorrhagic tumour	Sq	Visual field returned to normal, Gamma-Knife for residual
Zoia, 2014	32 yrs, F		Visual problems (temporal hemianopia RE and inferior-temporal field cut LE) during pregnancy	Intratumoral	Delivery via CS, endoscopic transsphenoidal subtotal resection and decompression of the optic chiasm, lumbar drainage for 6 days, and DDAVP	Ad	Vision returned to normal, RMN (3 mths later) small residual, and no chiasm compression

SDH: subdural hematoma; HA: headache; SAH: subarachnoid haemorrhage; Sq: squamous papillary, Ad: adamantinomatous, F-T: frontotemporal; DI: diabetes insipidus; DDAVP: desmopressin acetate, RE: right eye; LE: left eye; CS: caesarean section.