The outcome of 23 patients with tumours in the pineal region was investigated following treatment with shunting, irradiation, extirpation or with a combination of these three procedures. The choice of therapy is difficult because in most cases the kind of tumour is unknown. The irradiation of radioresistant lesions however causes an unnecessary injury of the surrounding tissue whereas the trial of extirpation of a radiosensitive tumour exposes the patient to an unnecessary danger. After the results of therapy a method of treatment is proposed.

After a short anatomical review about the neighbourhood of the lamina quadrigemina 23 patients with different processes in the pineal region were investigated with regard to their neurological symptoms and radiological findings. Symptoms of the eyes in conjunction with signs of elevated intracranial pressure in most of the cases show the way to the diagnosis which will be completed by ventriculography, angiography, and recently by computer tomography with regard to the expansion of the process; any prediction about the kind of tumour is possible only in a little percentage.