Imaging was performed, revealing a space-occupying lesion in the sellar region, diagnosed as craniopharyngioma, along with hydrocephalus. Hospitalization and surgery must be arranged as soon as possible; not a single day can be delayed.

A ten-year-old child experienced a rapid decline in vision within ten days. The parents initially thought it was myopia, but after repeated examinations, they found the problem was not in the eyes. Imaging was performed, revealing a space-occupying lesion in the sellar region, diagnosed as craniopharyngioma, along with hydrocephalus. Hospitalization and surgery must be arranged as soon as possible; not a single day can be delayed.

Although craniopharyngioma is a benign tumor, it grows in a critical location in the sellar region. Directly above it is the optic chiasm—the junction where the two optic nerves meet. As the tumor slowly grows, it compresses the optic chiasm upward. After the optic chiasm is compressed, the nerve fibers that transmit visual signals are impaired, and the patient will experience symptoms such as decreased vision and narrowing of the visual field. Many people initially go to the ophthalmology department for examination but find nothing wrong, because the lesion is in the brain, not in the eyes. This is also one of the reasons why craniopharyngioma is easily missed in the early stage.

If time drags on, the compression of the optic chiasm continues to worsen, and vision will further deteriorate. In severe cases, it may cause irreversible damage and complete blindness. At the same time, craniopharyngioma is also prone to causing hydrocephalus. The tumor compresses the third ventricle, blocking the circulation of cerebrospinal fluid and increasing intracranial pressure. The patient may also experience symptoms such as headache and vomiting. If a child has headache, vomiting, and vision loss at the same time, do not just treat it as a cold or gastroenteritis. Get a cranial imaging study as soon as possible to rule out problems in the sellar region.

Surgery is the only curative treatment. After the tumor is completely removed, the pressure on the optic chiasm is relieved, and there is a possibility of vision recovery. However, the degree of recovery depends on the duration and extent of compression. The earlier it is detected and the sooner the surgery is performed, the greater the chance of vision recovery. If surgery is delayed until the optic nerve has already atrophied, it will be very difficult to restore vision. Some patients experience significant improvement in vision after surgery, while others can only maintain their existing vision and prevent further deterioration. Therefore, once diagnosed, surgery should be arranged as soon as possible.

Although this tumor is benign, it is often extensively adhered to the optic nerve and surrounding large blood vessels, making the surgery quite risky. During the operation, the adhesion between the tumor and the optic nerve needs to be carefully separated under a microscope. The goal is to achieve complete resection without damaging the optic nerve and blood vessels. The biggest concern is residual microscopic tumor tissue during surgery, which could lead to recurrence later. It is recommended to be admitted to the hospital and arrange surgery as soon as possible; do not delay. One day earlier in surgery means one day earlier decompression of the optic chiasm and one more chance of preserving vision.