[Pineal cyst: its diagnosis and treatment].
ABSTRACT Four cases of pineal cyst were presented and their features on magnetic resonance (MR) imaging were discussed while reviewing the literature relevant to this clinical entity. Pineal cyst is a normal developmental variant and in most of the cases its diagnosis is not difficult, but in a limited number of cases, pineal cyst needs to be differentiated from cystic tumors which have developed in the region of the pineal gland, such as pineocytoma or astrocytoma. Most pineal cysts are found incidentally during MR screening studies and no surgical interventions are needed. Pineal cysts should be considered for surgery only when the diameter of the cyst is more than 1.0cm, or when obstructive hydrocephalus is verified on MRI or CT, and/or when definitive neurological signs such as Parinaud's syndrome are present. It was also stressed that embryological considerations are indispensable for evaluating pineal cysts on MR images.
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ABSTRACT: The management and outcome of 21 patients with tumors in the pineal region are reviewed. Nineteen patients underwent direct surgical approach. The identified tumors included: 5 germinomas, 1 atypical teratoma, 2 mature teratomas, 1 mixed tumor, 3 pineoblastomas, 1 pineocytoma, 2 gliomas, 1 cordoma, 2 cyst and 1 metastasis. Two others were presumptively germinomas. Preoperative staging should inCIude craniospinal MR imaging with and without gadolinium, CSF sampling for cytology, and measurement of tumor markers in serum and CSF. The authors believe that the preferred treatment for pineal tumors requires surgery with a histological diagnosis. Surgical approach is determined by the results of preoperative MR and the extension of the tumor. Postoperative treatment is based on histopathology and extension of the disease. Benign tumors are treated with surgery only. Craniospinal irradiation and systemic chemotherapy should be administered to those patients with malignant tumors, showing meningeal seeding, extraneural metastasis, or positive CSF cytology. There were no operative deaths and morbidity was minimal in our 21 patients.Neurocirugia (Asturias, Spain) 01/1997; 8(3):183–198. DOI:10.1016/S1130-1473(97)71029-7 · 0.32 Impact Factor
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ABSTRACT: Congenital malformations encompass a diverse group of disorders that often present at birth, either as the result of genetic abnormalities, infection, errors of morphogenesis, or abnormalities in the intrauterine environment. Congenital disorders affecting the brain are now often diagnosed before delivery with the use of prenatal ultrasonography. Over the past several decades, there have been major advances in the understanding and management of these conditions. This review focuses on the most common cranial congenital malformations, limiting the discussion to the neurosurgically relevant aspects of arachnoid cysts, pineal cysts, Chiari malformations, and encephaloceles.Neuroimaging Clinics of North America 08/2011; 21(3):705-17, ix. DOI:10.1016/j.nic.2011.05.008 · 1.29 Impact Factor