Shrey Patel, Benjamin Rahmani, Jason Gandhi, Omar Seyam, Gunjan Joshi, Inefta Reid, Noel L Smith, Wayne C Waltzer, Sardar Ali Khan
Introduction: The pineal gland, an endocrine organ of the posterior cranial fossa famously involved in sleep and wakefulness, has continually been a topic of scientific advancement and curiosity. Methods: We review present an up-to-date review including the anatomy, embryology, and physiology of the pineal gland and its ability to secrete hormones including melatonin, pathophysiology of pineal gland tumors, cysts, and calcifications, their clinical presentation including their association with parkinsonism and precocious puberty, and various treatment approaches...
May 2020: International Journal of Neuroscience
Norihiko Saito, Nozomi Hirai, Kazuya Aoki, Shusaku Takahagi, Akinori Yagihashi, Sho Sato, Ryo Suzuki, Yu Hiramoto, Morito Hayashi, Takatoshi Sakurai, Satoshi Iwabuchi
No abstract text is available yet for this article.
October 2019: No Shinkei Geka. Neurological Surgery
Joham Choque-Velasquez, Julio C Resendiz-Nieves, Behnam Rezai Jahromi, Roberto Colasanti, Rahul Raj, Kenneth Lopez-Gutierrez, Olli Tynninen, Mika Niemelä, Juha Hernesniemi
Background: Microsurgical resection represents a well-accepted management option for symptomatic benign pineal cysts. Symptoms such as a headache, hydrocephalus, and visual deficiency are typically associated with pineal cysts. However, more recent studies reported over the past years have characterized additional symptoms as a part of the clinical manifestation of this disease and represent additional indications for intervention. Methods: We present a retrospective review of patients with histologically confirmed benign pineal cysts that were operated on in our department between 1997 and 2015...
2019: Surgical Neurology International
Pawel Tabakow, Artur Weiser, Krzysztof Chmielak, Przemyslaw Blauciak, Joanna Bladowska, Marcin Czyz
Endoscopic cystocysternostomy or cystoventriculostomy is the treatment of choice in patients with symptomatic intracranial arachnoid cysts. There are no objective diagnostic tests for reliable intraoperative evaluation of the effectiveness of performed stomies. The aim of this prospective open-label study is to demonstrate for the first time the usefulness of intraoperative cysternography performed with the low-field 0.15-T magnetic resonance imager Polestar N20 during endoscopic cysternostomies. The study was performed in patients operated for middle fossa arachnoid cysts (n = 10), suprasellar cysts (n = 4), paraventricular or intraventricular cysts (n = 6), and a pineal cyst (n = 1)...
August 2020: Neurosurgical Review
Mina M Gerges, Saniya S Godil, Kavelin Rumalla, Benjamin Liechty, David J Pisapia, Rajiv S Magge, Theodore H Schwartz
Malignant transformation of intracranial epidermoid cysts is a rare occurrence. We present the second case of such an event occurring in the pineal region and the first case sent for detailed genomic profiling. MRI demonstrated two lesions: a cyst in a quadrigeminal cistern with restricted diffusion on DWI-weighted images and an adjacent, peripherally enhancing tumor with cerebellar infiltration. Both the lesions were completely resected with a small residual of the epidermoid cyst. The final pathology of both lesions was consistent with epidermoid cyst and squamous cell carcinoma (SCC), respectively...
July 2, 2019: Acta Neurochirurgica
Mathew Storey, Konstantinos Lilimpakis, Nora Sangvik Grandal, Chittoor Rajaraman, Shailendra Achawal, Masood Hussain
Objective: Pineal cysts are common benign incidental findings in adults. There are no commonly accepted criteria for follow up or indications for intervention. We looked at our outcomes for this condition to explore their natural history and review our surveillance criteria. Method: Retrospective review of multidisciplinary team meetings at a tertiary neurosurgical centre over 10 years. Data relating to demographics, presenting symptoms, maximum diameter, duration of surveillance, final diagnosis and overall outcome were extracted from electronic patient records and available MRI...
July 2, 2019: British Journal of Neurosurgery
Sameer Farouk Sait, Sofia Haque, Sasan Karimi, Karim J Rebeiz, Jasmine H Francis, Brian P Marr, David H Abramson, Mark M Souweidane, Ira J Dunkel
We attempted to investigate the potential role for apparent diffusion coefficient (ADC) to diagnose trilateral retinoblastoma (TRb) by retrospectively reviewing brain magnetic resonance images of retinoblastoma patients. Observations: The median ADC measured 620.95 for TRb (n=6) and 1238.5 for normal pineal gland in bilateral retinoblastoma (n=8). Monitoring ADC trends aided in establishing the appropriate diagnoses in 3 patients (2 TRb, 1 benign pineal cyst). Conclusions: Our results provide baseline reference data and describe the importance of downward trending ADC which should prompt consideration of TRb...
June 27, 2019: Journal of Pediatric Hematology/oncology
Sandy Dief, Analia Veitz-Keenan, Niloufar Amintavakoli, Richard McGowan
OBJECTIVES: Cone beam CT's use (CBCT) in dentistry is increasing. Incidental findings (IFs: discoveries unrelated to the original purpose of the scan), are frequently found as a result of a large field of view. The aim of the systematic review is to analyze present literature on IFs using CBCT. METHODS AND MATERIALS: The authors searched online databases of studies and assessed the prevalence of IFs among patients undergoing head and neck CBCT scans. STROBE criteria was used to evaluate the quality of the studies...
October 2019: Dento Maxillo Facial Radiology
Federico Bruno, Francesco Arrigoni, Nicola Maggialetti, Raffaele Natella, Alfonso Reginelli, Ernesto Di Cesare, Luca Brunese, Andrea Giovagnoni, Carlo Masciocchi, Alessandra Splendiani, Antonio Barile
The pineal gland can be involved in a variety of neoplastic and congenital masses and tumors. Pineal gland neoplasms occur more frequently in children, accounting for 3-8% of intracranial tumors in the pediatric population. Pineal cysts are small lesions usually asymptomatic and encountered incidentally. Pathologic processes involving the pineal region produce signs and symptoms related to the mass effect on the adjacent structures and invasion of surrounding structures. These include several acute symptoms, such as increased intracranial pressure syndrome from obstruction of the aqueduct and consequent hydrocephalus, and Parinaud syndrome...
April 2019: Gland Surgery
Joham Choque-Velasquez, Juha Hernesniemi
Background: Neuroepithelial cysts are benign, well-circumscribed, nonenhancing CSF-like masses that might virtually present in any intracranial location. Common locations are the frontal lobe, thalamus, midbrain and pons, vermis, the lateral and fourth ventricles, and the choroid fissure (Choroid fissure cysts). Usually asymptomatic, cysts in the posterior fossa have been reported to cause cranial nerve palsies, focal brainstem dysfunction, and hydrocephalus. Supratentorial cysts might cause seizures or focal motor and/or sensory deficits...
2019: Surgical Neurology International
Wenming Zhao, Dao-Min Zhu, Yu Zhang, Cun Zhang, Yajun Wang, Ying Yang, Ya Bai, Jiajia Zhu, Yongqiang Yu
Patients with major depressive disorder (MDD) often have circadian rhythm alteration and sleep disturbance. The pineal gland regulates the circadian rhythm and sleep by the secretion of melatonin neurohormone. However, the relationship between pineal abnormality and MDD remains elusive. 50 patients with MDD and 35 gender- and age-matched healthy controls underwent high-resolution structural MRI. Pineal parenchymal volume (PPV) was measured manually. Inter-group differences in prevalence of pineal cyst and PPV were examined...
July 30, 2019: Psychiatry research. Neuroimaging
Özlem Kara, Ihsan Esen, Derya Tepe, Nadide B Gülleroğlu, Meltem Tayfun
BACKGROUND The present study investigated the relationship between detection of organic pathologies with magnetic resonance imaging of the pituitary gland, clinical and laboratory findings, and treatment response. MATERIAL AND METHODS The study included a total of 183 patients who had isolated growth hormone deficiency, received at least 1 year of treatment, returned regularly for follow-ups, and whose pituitary magnetic resonance images were available. The patients were divided into 2 groups: those with and without pathological evidence with magnetic resonance imaging...
December 30, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Markus Lenski, Annamaria Biczok, Jörg-Christian Tonn, Friedrich-Wilhelm Kreth
INTRODUCTION: Treatment of symptomatic intracranial cysts remains a controversial issue. We here present the risk/benefit profile of a minimally invasive not yet described stereotactic internal shunt implantation technique. The provided data might serve as a reference against which other treatment modalities can be compared. MATERIALS AND METHODS: From our prospective data base we identified a consecutive series of patients with symptomatic, so far untreated cysts undergoing internal shunting (2009-2017)...
December 18, 2018: World Neurosurgery
Syed Ijlal Ahmed, Gohar Javed, Altaf Ali Laghari, Syeda Beenish Bareeqa, Kashif Aziz, Mehreen Khan, Syeda Sana Samar, Raja Azhar Humera, Alizay Rashid Khan, Muhammad Osama Farooqui, Amir Shahbaz
Third ventricle tumors are uncommon and account for 0.6 - 0.9% of all the brain tumors. Tumors of the third ventricle are classified into primary tumors, such as colloid cysts, choroid plexus papillomas, and ependymomas, or secondary tumors, such as craniopharyngiomas, optic nerve gliomas, pineal tumors, and meningiomas. Third ventricular tumors are uncommon, and their treatment involves significant morbidity and mortality. The colloid cyst has a better surgical outcome and many approaches are available to achieve a complete cure...
October 5, 2018: Curēus
David I Pitskhelauri, Alexander N Konovalov, Irakliy T Abramov, Gleb V Danilov, Igor N Pronin, Evgeniya V Alexandrova, Nataliya K Serova, Alexander Z Sanikidze
BACKGROUND: Pineal cysts (PCs) are histologically benign lesions of the pineal gland. Although the majority of PCs are asymptomatic, some cases are ambiguous and accompanied by nonspecific symptoms of variable severity. We suggested that disabling headache in nonhydrocephalic patients with PCs is associated with cerebral aqueduct (CAq) stenosis. METHODS: A retrospective analysis was conducted in patients with PCs suffering from headache without secondary hydrocephalus who underwent surgical resection at Burdenko Neurosurgery Center between 1995 and 2016...
March 2019: World Neurosurgery
Katherine Kunigelis, Alexander Yang, A Samy Youssef
This case is a 20-year-old male, who presented with 1 month of right facial weakness (HB4) and complaints of ipsilateral eye dryness. He was initially treated for Bell's palsy with steroids and antiviral agents, but subsequently developed diplopia with right lateral gaze and underwent an MRI (magnetic resonance imaging). MRI demonstrated a 4.5 cm irregular lesion in the right cerebellopontine angle consistent with an epidermoid cyst. Because the tumor had grown with the development of the central nervous system, it has extended into different compartments, including the tentorial incisura and pineal region...
December 2018: Journal of Neurological Surgery. Part B, Skull Base
Andrzej Koziarski, Andrzej Podgórski, Grzegorz M Zieliński
PURPOSE: Management of patients presenting for various nonspecific complaints without clear neurological abnormalities and with normal ventricular size remains highly controversial. We intended to share our rationale for surgical treatment of patients who show symptoms of transient increase of intracranial pressure owing to the presence of the cyst. MATERIALS AND METHODS: We have retrospectively analyzed 28 cases of patients who presented without Parinaud syndrome nor ventricular enlargement and underwent pineal cyst removal in our centre between 2007 and 2015...
November 19, 2018: British Journal of Neurosurgery
Ariana S Barkley, Chao-Hung Kuo, Sarah E S Leary, Jeffrey G Ojemann, Srinivas M Susarla
BACKGROUND: Primary intracranial teratomas account for <1% of intracranial masses during childhood after infancy. When supratentorial, they commonly occur in the pineal and suprasellar regions demonstrating multilocularity, areas of fat as well as calcifications and increasing enhancement correlating with decreased maturity. However, the presence of a teratoma as a mobile fat lesion within a large unilocular suprasellar cyst is rarely documented in this patient population. CASE DESCRIPTION: We present the first pediatric case of a suprasellar mature teratoma presenting as a mobile fat suppressing lesion within a large unilocular suprasellar cyst and describe a supraorbital approach with adjunctive use of the endoscope for resection...
October 24, 2018: World Neurosurgery
Juan C Fernandez-Miranda
In this video, we present the case of a 41-yr-old female with new onset of recurrent syncopal episodes. She underwent extensive evaluations and diagnostic work-up by cardiology and neurology, excluding any other cause than a large pineal cyst that was found on magnetic resonance imaging. Surgical indications for pineal cyst resection are very limited as most pineal cyst can be treated conservatively. Recurrent drop-attacks (without loss of consciousness) or syncopal episodes (with brief loss of consciousness) have been associated with pineal cysts secondary to a possible ball valve effect with shift of position causing sudden obstruction of the ventricular system followed by rapid rising of intracranial pressure...
October 5, 2018: Operative Neurosurgery (Hagerstown, Md.)
Ana Banc, Ioan-Ştefan Florian
BACKGROUND: Retinal optical coherence tomography (OCT) is a noninvasive high-resolution imaging technique, which is considered a biomarker of neurodegeneration. Several intracranial lesions can induce retrograde neurodegeneration which can be assessed using OCT. The cysts of the pineal region are usually asymptomatic and most often are an incidental radiologic finding. CASE DESCRIPTION: We describe the case of a 50-year-old woman with an arachnoid cyst of the pineal region who complained of visual symptoms for 3 months...
December 2018: World Neurosurgery
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