Symptoms of Childhood Craniopharyngioma

Executive Summary

Childhood Craniopharyngioma is diagnosed based on signs and symptoms. The symptoms and signs of craniopharyngioma in children are not known due to the slow progress of the tumor. The presence of the tumour in the brain can cause pressure build-up in the brain, hormonal variations, and damage to the nearby blood vessels and nerves, which may cause troubles with the brain’s normal functioning. Common childhood craniopharyngioma common signs and symptoms include moderate to severe headaches, vomiting and nausea, excessive fatigue or hypersomnia, balance issues, vision changes, behavioural changes, early or delayed puberty, frequent urge to urinate, adrenal insufficiency, and hypothyroidism.

Signs and Symptoms of Childhood Craniopharyngioma

Craniopharyngioma is a rare, usually benign form of brain tumor. It is seen to affect children between the age of 5 to 14 years. The tumor develops and grows in the brain, usually very close to the nasal passage. The tumor grows at a languid, gradual pace. 

The signs and symptoms of craniopharyngioma experienced by patients largely depend on the tumor’s location within the brain. Because of the tumor’s slow progress, people (including children) won’t know about its presence until they start experiencing any or some of the below-mentioned symptoms. The presence of the tumor in the brain can cause pressure build-up in the brain, hormonal variations, and damage to the nearby blood vessels and nerves, which may cause troubles with the brain’s normal functioning.

The following are some of the general signs and symptoms that children/adults may experience due to Craniopharyngioma ^​1​: 

Headaches are a common symptom of Craniopharyngioma. It could result from the tumor occupying space and creating unwanted pressure inside the brain. Sometimes headaches may be worse or severe during the early morning compared to any other time. Changing your head position while lying down may comfort or soothe your headache.

Vomiting and nausea are other common symptoms of craniopharyngioma ^​2​. People may experience nausea or vomiting after having food. Sometimes people will become nauseous and feel like vomiting even when they haven’t had enough food.

Increased urge to sleep or excessive fatigue is a sign of Craniopharyngioma. This can result from the tumor taking up space in the brain and exerting undue pressure. Undue pressure on the pituitary gland, causing endocrine problems associated with energy levels and sleep, can also cause Hypersomnia and fatigue.

People may feel that they are losing balance at times, indicating the presence of tumor growth in the brain. 

A tumour in the brain may cause a condition called bitemporal hemianopia, a medical term used to indicate partial blindness.

Sometimes the tumor may press right on the optic nerves (optic chiasm) that sense peripheral vision in both your eyes, causing partial blindness. In most cases, the loss of peripheral vision starts in one eye, and as the tumor grows, the other eye also gets affected.

Patients suffering from craniopharyngioma tumours may face constant behavioural changes or mood swings. Personality changes may also arise.

The following are symptoms of Craniopharyngioma resulting from hormonal deficiencies and other hypothalamic dysfunctions.

The pituitary glands secrete several vital hormones like growth hormones (GH), essential for growth throughout life. Several of these hormones (like gonadotrophins) regulates sexual maturation in adolescents. But craniopharyngioma tumors can affect the pituitary gland and its secretions. These tumors encroach the gland and interfere in its hormonal secretions, causing untimely, incomplete or delayed puberty in adolescents. 

These symptoms of craniopharyngioma indicate a condition called diabetes insipidus. It is a diabetes type characterized by polydipsia (excessive thirst and drinking) and polyuria (frequent urination)—the condition results from a deficiency in the ADH or antidiuretic hormone released by the pituitary gland. The ADH hormone regulates the fluids in our body. And when the body fails to make enough ADH, fluid loss happens via the urine. And it is this which makes us feel the constant urge to urinate or an excessive urge to drink fluids to compensate for the fluid loss from the body.

Another vital hormone secreted by the pituitary gland is ACTH or adrenocorticotropic hormone. The hormone is responsible for stimulating the adrenal glands in the body. A deficiency in this hormone can cause alterations in blood pressure, blood sugar, fatigue, changes in heart rate etc.

Another vital hormone secreted by the pituitary gland is the thyroid-stimulating hormone or TSH. TSH hormone stimulates the body’s thyroid gland. When this hormone is deficient, hypothyroidism occurs. Hypothyroidism can cause obesity or excessive weight gain, weakness, depression, irritability, and other health problems. 

If your child experiences any of the signs or symptoms of craniopharyngioma mentioned above, it is essential to consult a doctor and communicate the issues ^​3​. The doctor may enquire about how long and how often the patient has been experiencing these symptoms. Knowing such details can help the doctor make a correct diagnosis of the disease condition.

Suppose a CNS tumour condition like Craniopharyngioma is detected. In that case, managing and relieving symptoms of craniopharyngioma and the probable side effects of the treatment forms an integral part of the active treatment for your child. This part of the treatment is called palliative or supportive care.

In most cases, this is started soon after the disease is diagnosed and is continued throughout the treatment tenure ^​4​. Parents are urged to keep a check on their child’s condition and communicate with the health care team regarding any change in symptoms or signs of craniopharyngioma as and when the child is experiencing them, including any new symptoms or signs.

References