Disease Information for Pineal Cyst/Symptomatic

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Clinical Manifestations
Signs & Symptoms
Nausea
Relentless vomiting/retching/purging
Vomiting
Headache
Headache improved with position change
Headache, sudden severe and new type/Thunderclap
Headache/worsened by movement
Papilledema on exam
Blurred Optic Disk Margin
Upward gaze paralysis/sign
Upward gaze paralysis/voluntary
Disease Progression
Course/Chronic disorder
Course/Chronic only
Course/Lethal possible/not usual
Demographics & Risk Factors
Population Group
Child
Population/Pediatrics population
Sex & Age Groups
Population/Child
Population/Child-Infant Only
Population/Children/all
Diagnostic Test Results
Other Tests & Procedures
Lumbar puncture/Increased CSF pressure/LP test
CT Scan
CT Scan/Head Brain Cyst
CT Scan/Head Large third ventricle
MRI/Head Cystic lesion brain
X-RAY
Xray/Skull posterior fossa cyst/cystic
X-RAY With contrast
Pneumoencephalopathy/abnormal
Associated Diseases & Rule outs
Associated Disease & Complications
Cerebral cyst
Hydrocephalus
Hydrocephalus, acute acquired
Parinaud's Ophthalmoplegia
Disease Mechanism & Classification
Class
CLASS/Neurologic (category)
CLASS/Third ventricle involvement/disorder (ex)
Pathophysiology
Pathophysiology/CSF Pressure Increased
Process
PROCESS/Congenital/developmental (category)
PROCESS/Cysts (ex)
PROCESS/Structural/anatomic/foreign body (category)
PROCESS/Anomalies/Deformities/Malformations (EX)
Definition

Pineal cyst/symptomatic ball valve hydrocephalus, variable rare lethality;---------------------. Symptomatic glial cysts of the pineal gland; Small asymptomatic cysts of the pineal gland represent a common incidental finding in adults undergoing computerized tomography or magnetic resonance (MR) imaging or at postmortem examination; In contrast, large symptomatic pineal cysts are rare, being limited to individual case reports or small series; The authors have reviewed 24 cases of large pineal cysts. The mean patient age at presentation was 28.7 years (range 15 to 46 years); 18 were female and six male; Presenting features in 20 symptomatic cases included: headache in 19; nausea and/or vomiting in seven; papilledema in five; visual disturbances in five (diplopia in three, "blurred vision" in two, and unilateral partial oculomotor nerve palsy in one); Parinaud"s syndrome in two; hemiparesis in one; hemisensory aberration in one; and seizures in one; Four lesions were discovered incidentally; Magnetic resonance imaging typically demonstrated a 0_8- to 3_0-cm diameter mass (mean 1_7 cm) with homogeneous decreased signal intensity on T1-weighted images, increased signal intensity on T2-weighted images, and a distinct margin; Hydrocephalus was present in eight cases [40%]; The cysts were surgically excised via an infratentorial/supracerebellar approach (23 cases) or stereotactically biopsied (one case); Histological examination revealed a cyst wall 0_5 to 2_0 mm thick comprised of three layers: an outer fibrous layer, a middle layer of pineal parenchymal cells with variable calcification, and an inner layer of hypocellular glial tissue often exhibiting Rosenthal fibers and/or granular bodies; Evidence of prior hemorrhage, mild astrocytic degenerative atypia, and disorganization of pineal parenchyma were often present; Postoperative follow-up review in all 24 cases (range 3 months to 10 years) revealed no complications in 21, mild ocular movement deficit in one, gradually resolving Parinaud"s syndrome in one, and radiographic evidence of a postoperative venous infarct of the superior cerebellum with ataxia of 1 week"s duration in one; Of the patients referred for study, the cysts were most often initially misdiagnosed as a pineocytoma in eight and a pilocytic astrocytoma in three; Only two patients were correctly diagnosed as having pineal cysts; This stresses the importance of recognizing the histopathological spectrum of pineal cysts, as well as correlation with radiographic findings, if a correct diagnosis is to be attained; [PubMed/Mayo Clinic 2004]

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External Links Related to Pineal Cyst/Symptomatic
Google
Wikipedia
Merck
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PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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