Neuroimaging in emergency: a review of possible role of pineal gland disease

Bruno, Federico; Arrigoni, Francesco; Maggialetti, Nicola; Natella, Raffaele; Reginelli, Alfonso; Cesare, Ernesto Di; Brunese, Luca; Giovagnoni, Andrea; Masciocchi, Carlo; Splendiani, Alessandra

doi:10.21037/gs.2019.01.02

Cited by 12 publications

(12 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, only a few patients with pineal cysts requires treatment. In fact, as previously reported, pineal cysts usually have no clinical implications and are asymptomatic [ 119 , 126 , 127 ].…”

Section: A Brief Overview Of Other Neoplastic and Non-neoplastic Pmentioning

confidence: 71%

Pineal Gland Tumors: A Review

Favero

Bonomini

Rezzani

2021

Cancers

View full text Add to dashboard Cite

The pineal gland is a small, pinecone-shaped endocrine gland that participates in the biological rhythm regulation of vertebrates. The recognized major product of the pineal gland is melatonin—a multifunctional endogenous indoleamine. Accumulating evidence suggests that the pineal gland is important for preserving ideal health conditions in vertebrate. Tumors of the pineal region account for approximately 3–11% of pediatric brain neoplasms but fewer than 1% of brain neoplasms in adults. It is fundamental to expand advanced imaging techniques together with both clinical and laboratory knowledge, to help to differentiate among pineal neoplasms and thus facilitate accurate primary diagnoses and proper therapeutic interventions. In this review, we report the gross anatomy of the pineal gland and its functional significance and discuss the clinical relevance of pineal gland tumors, underlining the importance of identifying the leading causes of pineal region masses.

show abstract

Section: A Brief Overview Of Other Neoplastic and Non-neoplastic Pmentioning

confidence: 71%

Pineal Gland Tumors: A Review

Favero

Bonomini

Rezzani

2021

Cancers

View full text Add to dashboard Cite

show abstract

“…The occurrence of ischemic pineal apoplexy is highly speculative because it cannot be confirmed by any diagnostic tool. 36 Some authors attributed cases of spontaneous regression of pineal lesions to ischemic pineal apoplexy. [37][38][39] A precipitating event that leads to bleeding is unknown in most cases.…”

Section: Discussionmentioning

confidence: 99%

Pineal Apoplexy: A Case Series and Review of the Literature

Májovský

Netuka

Lipina

et al. 2021

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

Background Pineal apoplexy is a rare condition, with unknown incidence and clinical significance. To elucidate this clinical condition, we analyzed our own case series and performed a review of the literature. Methods We enrolled all patients with a hemorrhagic pineal apoplexy who were referred to our department between January 2000 and January 2020. Hemorrhagic pineal apoplexy was defined as the presence of fluid–fluid levels inside the pineal cyst (PC) on an axial or sagittal magnetic resonance scan. In one patient, after PC apoplexy, we performed a circadian melatonin sampling from peripheral blood to determine the function of the pineal gland. The PubMed database was searched for publications using the terms “pineal” and “apoplexy.” Results Eight patients were enrolled, of which three patients underwent surgical treatment and five patients were managed conservatively. One patient was tested for circadian melatonin secretion. Results confirmed melatonin secretion with preserved physiologic circadian rhythm.Our search of the literature led us to 31 studies that comprised 30 patients with apoplectic PC, 9 with apoplectic pineal tumor, and 1 with bleeding into the normal pineal gland. Most patients presented with headache, nausea, and vomiting, less frequently with acute hydrocephalus and gaze palsy. Twenty patients with a PC underwent resection or aspiration. Two patients underwent shunt placement as the only procedure and five received both shunt and surgical removal. Six patients with a PC were observed without surgical treatment. All the nine patients with a pineal tumor were operated on. In indicated cases, four patients received radiation therapy and one received chemotherapy. Conclusion Clinical significance of hemorrhagic pineal apoplexy ranges from an asymptomatic course to rapid deterioration and death. In patients with mild symptoms, observation is indicated, whereas surgical treatment is reserved for severe cases presenting with obstructive hydrocephalus and includes cerebrospinal fluid diversion, resection of apoplectic pineal lesions, or both.

show abstract

“…To understand this unusual presentation, we must focus on the importance of the pineal gland anatomy. The pineal gland is a small structure, variable in size of about 5 mm, located in the midline, above the tentorium, and below the splenium of the corpus callosum [11]. It is connected through the pineal stalk to the posterior roof of the third ventricle.…”

Section: Discussionmentioning

confidence: 99%