Tomoko Tanaka, Lauren Arnold, Dana Gabriela Mazuru, Mojgan Golzy, Steven B Carr, N Scott Litofsky
Pineal cysts are a common incidental finding on brain magnetic resonance imaging (MRI) whichfrequently prompts referral to neurosurgery. Currently, a management algorithm for patientswithout hydrocephalus, Parinaud's syndrome, or pineal apoplexy is lacking.We aimed to identifypredictive factors of pineal cyst volume change andsurgical intervention by performing retrospective chart review of 98 patients between 2005 and 2018 diagnosed with pineal cysts gleaned from our Neurosurgery clinical databases.We included patients whose initial and follow-up MRIs were available in our institutional radiology system or whose surgical pathology confirmed pineal cyst after evaluation with an initial MRI...
November 30, 2020: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Joham Choque-Velasquez, Julio C Resendiz-Nieves, Szymon Baluszek, Roberto Colasanti, Sajjad Muhammad, Juha Hernesniemi
Background: Microsurgical removal represents a well-accepted treatment option for symptomatic benign pineal cysts (PCs). However, very few studies have quantitatively evaluated the functional status of surgically treated PC patients. Methods: A detailed analysis of preoperative, immediate postoperative, and long-term clinical and radiological characteristics was performed. The functional status of the patients was categorized using the modified Rankin scale (mRS) and the Chicago Chiari Outcome Scale (CCOS)...
2020: Surgical Neurology International
Riki Tanaka, Kazuhito Takeuchi, Ahmed Ansari, Kento Sasaki, Kyosuke Miyatani, Yasuhiro Yamada, Tsukasa Kawase, Yoko Kato, Akihiko Horiguchi
Background: The endoscopic supracerebellar-infratentorial (SCIT) approach is a viable method to access pathology of the posterior incisura, but a narrow working space and frequent instrument conflict can potentially limit its surgical efficacy. We planned an endoscopic-assisted paramedian infratentorial supracerebellar approach for pineal cyst. Case Description: Patient was placed in prone position under general anesthesia. His head was rotated to the left side slightly...
2020: Surgical Neurology International
Inna Bukreeva, Olga Junemann, Alessia Cedola, Francesca Palermo, Laura Maugeri, Ginevra Begani Provinciali, Nicola Pieroni, Alessia Sanna, Dmitry A Otlyga, Alexey Buzmakov, Yuri Krivonosov, Denis Zolotov, Marina Chukalina, Anna Ivanova, Sergey Saveliev, Victor Asadchikov, Michela Fratini
Pineal gland (PG) is a part of the human brain epithalamus that plays an important role in sleep, circadian rhythm, immunity, and reproduction. The calcium deposits and lesions in PG interfere with normal function of the organ and can be associated with different health disorders including serious neurological diseases. At the moment, the detailed mechanisms of PG calcifications and PG lesions formation as well as their involvement in pathological processes are not fully understood. The deep and comprehensive study of the structure of the uncut human PG with histological details, poses a stiff challenge to most imaging techniques, due to low spatial resolution, low visibility or to exceedingly aggressive sample preparation...
October 24, 2020: Journal of Structural Biology
B Özcabi, G Akay, G Yesil, E Uyur Yalcin, H Kirmizibekmez
Sotos syndrome is characterized by overgrowth, macrocephaly, distinctive facial features, and learning disabilities and is associated with alterations in the nuclear receptor binding SET domain protein 1 (NSD1) gene. Due to the advanced bone age, the eventual adult height is usually at the upper limit of normal. In this case report, a 6-year and 10-month old boy who presented with Sotos syndrome was described. He also had increased testicular volumes with advanced bone age. The stimulated levels of gonadotropins revealed central precocious puberty and brain magnetic resonance imaging (MRI) showed a pineal cyst...
April 2020: Acta endocrinologica: the international journal of the Romanian Society of Endocrinology
Koushik Handattu, Ramesh Bhat Yellanthoor, Sandesh Kini
An 11-year-old boy presenting with sudden onset double vision, headache and neck pain was found to have left lateral rectus palsy, papilledema and neck rigidity. An initial diagnosis of benign intracranial hypertension was considered. However, magnetic resonance imaging (MRI) of the brain surprisingly discovered the pineal gland cyst. He underwent Krause´s procedure for the excision biopsy of the cyst. Histopathological examination confirmed epidermoid cyst. Postoperatively, he had transient ataxia and upgaze palsy but recovered well...
2020: Pan African Medical Journal
Kristine Woodward, Amith Sitaram, Steven Peters
This case report describes a patient who presented to the emergency department with intermittent visual disturbance and was found to have convergence-retraction nystagmus. This occurred in the setting of supratherapeutic anticoagulation on warfarin for an aortic dissection graft repair. Urgent imaging demonstrated haemorrhagic transformation of a previously identified incidental pineal cyst. After close monitoring given the risk of secondary hydrocephalus, the patient was discharged in stable condition with symptom resolution and without any further significant complications...
September 14, 2020: BMJ Case Reports
Marcin Birski, Jacek Furtak, Kamil Krystkiewicz, Julita Birska, Karolina Zielinska, Paweł Sokal, Marcin Rusinek, Dariusz Paczkowski, Lukasz Szylberg, Marek Harat
Stereotactic biopsies of ventricular lesions may be less safe and less accurate than biopsies of superficial lesions. Accordingly, endoscopic biopsies have been increasingly used for these lesions. Except for pineal tumors, the literature lacks clear, reliable comparisons of these two methods. All 1581 adults undergoing brain tumor biopsy from 2007 to 2018 were retrospectively assessed. We selected 119 patients with intraventricular or paraventricular lesions considered suitable for both stereotactic and endoscopic biopsies...
August 21, 2020: Neurosurgical Review
Eric Bozier, Alexandre Carpentier, Caroline Apra
No abstract text is available yet for this article.
August 14, 2020: World Neurosurgery
Joham Choque-Velasquez, Roberto Colasanti, Szymon Baluszek, Julio Resendiz-Nieves, Sajjad Muhammad, Christopher Ludtka, Juha Hernesniemi
INTRODUCTION: We present a consecutive case series and a systematic review of surgically treated pediatric PCs. We hypothesized that the symptomatic PC is a progressive disease with hydrocephalus at its last stage. We also propose that PC microsurgery is associated with better postoperative outcomes compared to other treatments. METHODS: The systematic review was conducted in PubMed and Scopus. No clinical study on pediatric PC patients was available. We performed a comprehensive evaluation of the available individual patient data of 43 (22 case reports and 21 observational series) articles...
July 20, 2020: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Yadira Flores-Montanez, Stephanie J Nahas
PURPOSE OF REVIEW: We describe a series of cases with unusual brain MRI findings in patients who present with headache disorders. RECENT FINDINGS: Incidental findings in patients imaged for headache include the following: aneurysm, arachnoid cyst, cerebral vascular malformations, Arnold-Chiari malformations, empty sella turcica, gray matter heterotopias, mastoiditis, mega cisterna magna, meningioma, normal variants of cerebral circulation, paranasal sinus disease, pineal cyst, pituitary tumor, Rathke's cleft cyst, skull hyperostosis, and vestibular schwannoma...
July 20, 2020: Current Pain and Headache Reports
Dylan Goehner, Dallas Soyland, Eric Trumble, Shawn Vuong
BACKGROUND: Pineal cysts are common, typically asymptomatic, and are usually found incidentally in adults. In rare cases, pineal cyst apoplexy occurs as a result of an acute cystic hemorrhage. This can result in acute onset of severe headaches, acute obstructive hydrocephalus, mass effect on the midbrain, and even death. Pineal apoplexy is most common in reproductive age women, while pediatric cases continue to be less prevalent. Pineal cyst apoplexy remains a rare entity with 30+ cases presented in the literature to date...
June 29, 2020: World Neurosurgery
Avivit Brener, Danil A Kozyrev, Shelly I Shiran, Erez Azoulay, Li-Tal Pratt, Ronit Precel, Liat Ben-Sira, Ori Eyal, Shlomi Constantini, Jonathan Roth, Yael Lebenthal
Objective To explore incidental findings on brain magnetic resonance imaging (MRI) studies of pediatric patients referred due to endocrine disorders. Methods A retrospective, observational study conducted in a tertiary referral center. The neuroimaging database of 17,445 brain MRI studies of 11,011 pediatric patients were searched for cases with endocrine referrals and without medical history of malignancy, genetic syndromes and/or neurological comorbidities. This database was linked to the pediatric neurosurgical database...
June 23, 2020: Endocrine Practice
Laurence Davidson
OBJECT: The purpose of this study was to evaluate whether endoscopic third ventriculostomy (ETV) and endoscopic cyst fenestration are effective minimally invasive alternatives to a craniotomy with cyst resection for the treatment of symptomatic pineal cyst-associated aqueductal stenosis. METHODS: Sixteen patients with symptomatic pineal cysts were operatively managed endoscopically and these cases were retrospectively reviewed. There were 12 females and 4 males...
June 19, 2020: Acta Neurochirurgica
Tsutomu Takahashi, Daiki Sasabayashi, Murat Yücel, Sarah Whittle, Valentina Lorenzetti, Mark Walterfang, Michio Suzuki, Christos Pantelis, Gin S Malhi, Nicholas B Allen
Abnormal melatonin secretion has been demonstrated in patients with affective disorders such as major depressive disorder (MDD) and bipolar disorder (BD). However, magnetic resonance imaging (MRI) studies that previously investigated the volume of the pineal gland, which regulates circadian rhythms by secreting melatonin, in these patients reported inconsistent findings. The present study employed MRI to examine pineal gland volumes and pineal cyst prevalence in 56 MDD patients (29 currently depressed and 27 remitted patients), 26 BD patients, and matched controls (33 for MDD and 24 for BD)...
2020: Frontiers in Psychiatry
Chiao-Fan Chiu, Chao-Jan Wang, Yi-Pin Chen, Fu-Sung Lo
Background: Whether girls with central precocious puberty (CPP) should undergo routine brain magnetic resonance imaging (MRI) to identify potential intracranial pathologies is controversial. Aims: To evaluate the brain MRI results of girls with CPP and identify the clinical and endocrine predictors of brain abnormalities. Methods: This retrospective study obtained data from pediatric endocrine clinics at Chang Gung Children's Hospital. From 1997 and 2017, 403 girls were consecutively diagnosed with CPP. After the exclusion of patients with a history of central nervous system (CNS) insults or associated neuropsychiatric symptom or signs, we studied the prevalence of brain abnormalities in 251 girls with CPP who received detailed MRI examinations of the hypothalamus and pituitary area...
2020: Frontiers in Endocrinology
El Kim, Sae Min Kwon
Pineal cysts (PCs) are often encountered as incidental findings in intracranial images. The vast majority of cysts are normally asymptomatic and clinically benign. Bleeding into the cysts, which leads to neurological symptoms and signs, is considered to be quite rare. The authors illustrate a newly identified complication of PC in a 56-year-old woman who characterized by headache of sudden onset and vomiting. MRI disclosed a small hemorrhagic PC without narrowing of the cerebral aqueduct. The patient was managed conservatively without any surgical interventions, and she remained symptom-free over a period of 15-year follow-up...
April 2020: Brain Tumor Research and Treatment
Ahmed Ammar, Abdulrazaq Abdulmohsen Alojan, Alaa Nabil Turkistani, Majd Mohammed Alrayes
Arachnoid cyst is a rare benign cerebrospinal fluid-filled cyst that can develop anywhere in the brain along the arachnoid membrane and usually unaccompanied by the anomalous development of the brain structure. These cysts are usually located in the middle cranial fossa. However, they are also denoted in other regions. Arachnoid cysts are mostly asymptomatic and diagnosed incidentally. Spontaneous regression of arachnoid cysts in different anatomical regions of the brain has been reported in the literature...
January 2020: Asian Journal of Neurosurgery
Joham Choque-Velasquez, Julio Resendiz-Nieves, Behnam Rezai Jahromi, Roberto Colasanti, Szymon Baluszek, Sajjad Muhammad, Juha Hernesniemi
OBJECTIVE: The midline supracerebellar infratentorial (SCIT) approach and its paramedian development are commonly used for dealing with pineal lesions. Comparative clinical studies are lacking, however. We aim to establish the better performance of the paramedian SCIT approach in terms of clinical safety in surgically treated pineal cysts and pineal region tumors. Procedural functionality and effectiveness have been also analyzed. METHODS: A comparative analysis of clinical, radiologic, pathologic, and surgical features, and outcome was performed between 55 midline and 57 paramedian SCIT approaches that were exclusively performed in 112 patients (57 pineal cysts and 55 tumors of the pineal region) operated in sitting position by a single surgeon...
January 28, 2020: World Neurosurgery
Mark K Lukewich, Laila Alshafai, Jonathan A Micieli
BACKGROUND: Pineal lesions are common causes of dorsal midbrain syndrome and typically require surgical intervention in symptomatic patients. We describe a unique case of spontaneous resolution of dorsal midbrain syndrome resulting from a pineal gland cyst. CASE DESCRIPTION: A 23-year-old woman developed a supranuclear upgaze palsy, convergence-retraction nystagmus, and light-near dissociation from a pineal gland cyst (1.0 × 1.3 × 1.2 cm) with mild mass effect on the posterior surface of the tectum...
April 2020: World Neurosurgery
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