Pineal Cyst: A Review of Clinical and Radiological Features

Choy, Winward; Kim, Won; Spasić, Marko; Voth, Brittany; Yew, Andrew; Yang, Isaac

doi:10.1016/j.nec.2011.06.001

Cited by 29 publications

(43 citation statements)

References 55 publications

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“…[1][2][3] Although commonly identified during workup for headaches, in the majority of cases, they are not the source of symptoms. [1][2][3]6,8,22 In rare cases, large cysts may obstruct the cerebral aqueduct, causing ventriculomegaly or compress the tectum, causing Parinaud's syndrome. 7,10,11,15,18,26 In our practice we have treated 3 patients who presented with hydrocephalus caused by compression of the aqueduct by a pineal cyst.…”

Section: Discussionmentioning

confidence: 99%

Pineal cyst resection in the absence of ventriculomegaly or Parinaud's syndrome: clinical outcomes and implications for patient selection

Kalani

Wilson

Koechlin

et al. 2015

JNS

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OBJECT Surgical indications for patients with pineal cysts are controversial. While the majority of patients harboring a pineal cyst require no treatment, surgery is a well-accepted option for a subset of those patients with secondary hydrocephalus or Parinaud's syndrome. The majority of pineal cysts are identified incidentally during workup for other potential conditions, which may or may not be related to the presence of the cyst. In the absence of clear obstruction of CSF pathways, the treatment of presumed symptomatic pineal cysts is debatable. To clarify the role of surgery in these borderline cases, the authors reviewed their experience with resection of pineal cysts in the absence of ventriculomegaly or Parinaud's syndrome. METHODS The authors retrospectively reviewed medical records and imaging of all patients surgically treated between 2001 and 2014 with a pineal cyst in the absence of ventriculomegaly and Parinaud's syndrome. The presenting symptoms, preoperative cyst size, preoperative radiographic aqueductal compression, extent of resection, and radiographic and clinical follow-up were documented. RESULTS Eighteen patients (14 female and 4 male; mean age 24 years, range 4–47 years) underwent cyst resection in the absence of ventriculomegaly or Parinaud's syndrome. Presenting symptoms included headache (17 patients), visual disturbances (10 patients), gait instability (5 patients), dizziness (5 patients), episodic loss of consciousness (2 patients), and hypersomnolence (1 patient). The mean preoperative cyst diameter was 1.5 cm (range 0.9–2.2 cm). All patients had a complete resection. At a mean clinical follow-up of 19.1 months (range postoperative to 71 months), 17 (94%) patients had resolution or improvement of their presenting symptoms. CONCLUSIONS The authors' results suggest that ventriculomegaly and Parinaud's syndrome are not absolute requisites for a pineal cyst to be symptomatic. Analogous to colloid cysts of the third ventricle, intermittent occlusion of cerebrospinal fluid pathways may cause small pineal cysts to become intermittently symptomatic. A select cohort of patients with pineal cysts may benefit from surgery despite a lack of hydrocephalus or other obvious compressive pathology.

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Section: Discussionmentioning

confidence: 99%

Pineal cyst resection in the absence of ventriculomegaly or Parinaud's syndrome: clinical outcomes and implications for patient selection

Kalani

Wilson

Koechlin

et al. 2015

JNS

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“…Он встречался у 107 (81%) пациентов из 132, пролеченных хирургически. Стоит отметить, что у части этих пациентов (26%) головная боль была следствием кровоизлияния в кисту и возникшей гидроцефалии, а в 35% -следствием гидроцефалии без кровоизлияния в КШТ [5,36,45,[48][49][50][51][52][53]. В исследовании методом «случай-контроль», проведенным Seifert, в котором изучалась связь между головной болью и КШТ, выявлено, что при сравнительном анализе по половым и возрастным признакам головную боль диагностировали в 2 раза чаще у пациентов с наличием кисты, чем в контрольной группе (51% против 25%), а самым частым типом головной боли у пациентов с кистой была мигрень (26%) [53].…”

Section: головная больunclassified

Pineal cyst

Abramov¹,

Pitskhelauri²,

Serova³

2017

Vopr. neirokhir.

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“…63 Pineal cysts become increasingly common during childhood before peaking in frequency in early adulthood. 45,48,52,64 46,62 Large studies with imaging follow-up demonstrate that changes in pineal cyst size are rare, that pineal cysts more often decrease in size than increase, and that pineal cysts are not commonly associated with symptoms.…”

Section: Pineal Cystsmentioning

confidence: 99%