Microsurgical topography of craniopharyngiomas.

The relationship of craniopharyngiomas to surrounding structures was studied by stereoscopic and light microscopy in 30 autopsies. The localization of 4 of the tumors was intra- and suprasellar, 26 lesions were primarily suprasellar. Suprasellar craniopharyngiomas were divided into three groups according to their relationship to the floor of the third ventricle: extraventricular, intra extraventricular and intraventricular. The different localization of craniopharyngiomas in the vertical axis is a codeterminant of the direction and extent of tumor growth in the horizontal plane at the base of the brain. Comparison of these anatomical data and additional anatomical findings obtained in primary microsurgical operations of another 16 patients with the results of plain X-ray and contrast studies revealed radiological features characteristic of different topographic groups. The choice of the most adequate approach and degree of radicality of surgery for craniopharyngiomas can be based on the results of pre-operative neuroradiological investigations.