Introduction: Craniopharyngiomas are benign neoplasms of the sellar/suprasellar region. Management of these lesions always poses a challenge to neurosurgeons. Methods: Between 2012 and 2016, a total of 27 paediatric patients (8-16 year age) underwent surgery for craniopharyngiomas with a goal of total surgical removal without neurological risk. All patients were operated via frontopterional approach under operating microscope. Radiotherapy was offered to 7 patients in which partial decompression and excision was done. Results: Majority of the cases (21/27) 77% were large tumours with suprasellar extension and both supradiaphragmatic and infradiaphragmatic components. Complete resection was achieved in 13/27 (48%) of the cases. Neuropsychological sequele were seen in six children. Three children had memory deficits and behavioural problems (aggressiveness and lack of attention) and 3 had change in personality. Conclusion: We conclude that radical resection of craniopharyngiomas with perseveration of the pituitary stalk should be the goal of surgery. However; one should not be overly aggressive in approach for these tumors as radiotherapy also has a proven role in their management.

Keywords: Paedriatic Craniopharyngioma; Resection; Radiotherapy.