Pineal cysts - a benign consequence of mild hypoxia in a near-term brain?

Department of Pediatric Neurology, University Medical Centre, Ljubljana, Slovenia.
Neuro endocrinology letters (Impact Factor: 0.94). 01/2011; 32(5):663-6.
Source: PubMed

ABSTRACT Pineal cysts are benign glial uniloculated or multiloculated fluid-filled sacs located in the pineal gland region. Small pineal cysts are often found incidentally in healthy adults in 1.5-10.8%. Large cysts may cause neurological problems due to pressure exertion on adjacent structures.
We have used prospective, observational study of an inception cohort of 16 adolescents of mean age 21.69 years (SD=±0.87) with mild (68.7%) to moderate (31.3%) HIE: 7 girls (43.8%) and 9 (56.3%) boys, born with mean gestational age of 35.75 weeks (SD=±3.80) and mean birthweight of 2 644 g (SD=±815). HIE was confirmed by presence of abnormal CTG and/or meconium and/or Apgar scores less than 7 at 5 minutes and/or need for resuscitation and/or cord pH less than 7.2 and /or BE more than -15. The clinical assessment of HIE was done according to the Sarnat-Sarnat scoring. Neonatal data, including EEG and imaging data, were collected. Adolescents were scanned with 3T Magnetom Trio Tim, Siemens, head coil 12 channels, regular sequences and sagittal 3D magnetization-prepared rapid acquisition gradient echo (MPRAGE) sequence with voxel size 1 mm3. Neurological outcome was determined.
In 1 patient we found cortical dysplasia and 1 had a panic attack hence their data were omitted. In the group of 14 we have incidentally found in 5 patients a larger, asymptomatic pineal cysts with the overall incidence of 36%. Other MR findings in the group were in 50% white matter injury, in 50% thinner corpus callosum. No statistically significant difference between neonatal cUS and late follow-up MRI (p=0.881) was found. Correlation was not significant with Spearman correlation coefficient 0.201. Presence of pineal cysts was linked to thinner corpus callosum (p=0.005).
We propose that larger pineal cyst, in the absence of other imaging findings except for thinner corpus callosum, is a benign consequence of mild hypoxia in a near-term brain. Our findings warrant a larger study.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although the prevalence of pineal cysts in autopsy series has been reported as being between 25% and 40%, MR studies have documented their frequency to range between 1.5% and 10.8%. The purpose of this high-resolution brain MR imaging study at 1.9T was to determine the prevalence of pineal cysts in healthy adults. Brain MR images of 100 healthy young volunteers were randomly selected from our International Consortium for Brain Mapping project data base. Cysts were detected as circular areas of isointensity relative to CSF on both 3D gradient-echo T1-weighted and 2D fast spin-echo T2-weighted images. The inner diameters of all visualized pineal cysts were measured, and a criterion of 2.0 mm of the largest inner cross-sectional diameter was used to categorize cysts as being either small cystic changes (<2.0-mm diameter) or pineal cysts (>2.0-mm diameter). Twenty-three percent (23/100) of the volunteers had pineal cysts with a mean largest inner cross-sectional diameter of 4.3 mm (range, 2-14 mm); 13% (13/100) demonstrated cystic changes involving the pineal gland with the largest inner cross-sectional diameter of less than 2.0 mm. There was a slight female predominance. Two subjects with long-term follow-up scans showed no symptoms or changes in the size of their pineal cysts. On high-resolution MR imaging, the prevalence of pineal cysts was 23% in our healthy group of adults, which is consistent with previous autopsy studies. Long-term follow-up studies of 2 cases demonstrated the stability of the cysts.
    American Journal of Neuroradiology 11/2007; 28(9):1706-9. DOI:10.3174/ajnr.A0656 · 3.68 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To use MR imaging in the analysis of the size of the normal pineal gland in infants, children, and adolescents. We retrospectively analyzed the size of the pineal gland in 249 patients (129 male and 120 female) aged 2 weeks to 20 years old. The maximum length (L), height (H), and width (W) of the gland were determined from a combination of sagittal, coronal, and axial MR images obtained on a 1.5-T scanner. The volume was calculated by using the formula 1/2 x L x H x W. The size of the pineal gland was significantly smaller in patients younger than 2 years old than in older patients. The size of the pineal gland increased until 2 years of age and remained stationary between the ages of 2 and 20 years. We found a large variation in size among all age groups. No difference in size was noted between males and females. This study establishes norms for pineal gland size in infants younger than 2 years old and in children and adolescents 2 to 20 years old as detected with MR imaging. Knowledge of the size of the normal pineal gland is important in the detection of abnormalities of the pineal gland, particularly neoplasms.
    American Journal of Neuroradiology 03/1996; 17(2):233-6. · 3.68 Impact Factor
  • The Journal of Pathology 09/1971; 105(1):31-9. DOI:10.1002/path.1711050105 · 7.33 Impact Factor


Available from
Aug 5, 2014