Nonneoplastic pineal cysts: A clinicopathologic study of twenty-one cases

Mena, Hernando; Armonda, Rocco A.; Ribas, Jorge L.; Ondra, Steven; Rushing, Elisabeth J.

doi:10.1016/s1092-9134(97)80004-4

Cited by 65 publications

(38 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Rarely, pineal cysts have been associated with gaze palsy or Parinaud syndrome. 11,17,29,36,39,40,46,47,67,69 We did not have any patients with either of these clinical manifestations in our series. The frequent association of other, likely incidental, symptoms with pineal cysts will make the clinical interpretation of any symptoms challenging.…”

Section: Discussionmentioning

confidence: 92%

“…Pineal cysts are known to have fibrillary astrocytes and occasional Rosenthal fibers and demonstrate reactivity on glial fibrillary acidic protein and S100 protein staining. 17,20,39 There are multiple reported examples of histological misdiagnosis. 17,20,26,29,39,69 Fain et al 17 reported that 3 of the 24 pineal cysts in their series were previously histologically misdiagnosed as tumors.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence and natural history of pineal cysts in adults

Al-Holou¹,

Terman²,

Kilburg³

et al. 2011

JNS

View full text Add to dashboard Cite

Object We reviewed our experience with pineal cysts to define the natural history and clinical relevance of this common intracranial finding. Methods The study population consisted of 48,417 consecutive patients who underwent brain MR imaging at a single institution over a 12-year interval and who were over 18 years of age at the time of imaging. Patient characteristics, including demographic data and other intracranial diagnoses, were collected from cases involving patients with a pineal cyst. We then identified all patients with pineal cysts who had been clinically evaluated at our institution and who had at least 6 months of clinical and imaging follow-up. All inclusion criteria for the natural history analysis were met in 151 patients. Results Pineal cysts measuring 5 mm or larger in greatest dimension were found in 478 patients (1.0%). Of these, 162 patients were male and 316 were female. On follow-up MR imaging of 151 patients with pineal cyst at a mean interval of 3.4 years from the initial study, 124 pineal cysts remained stable, 4 increased in size, and 23 decreased in size. Cysts that were larger at the time of initial diagnosis were more likely to decrease in size over the follow-up interval (p = 0.004). Patient sex, patient age at diagnosis, and the presence of septations within the cyst were not significantly associated with cyst change on follow-up. Conclusions Follow-up imaging and neurosurgical evaluation are not mandatory for adults with asymptomatic pineal cysts.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Prevalence and natural history of pineal cysts in adults

Al-Holou¹,

Terman²,

Kilburg³

et al. 2011

JNS

View full text Add to dashboard Cite

show abstract

“…Sudden death in the setting of acute hydrocephalus with rapid increase of the intracranial pressure, is a well recognised situation in which an underlying pathology or cause can be established in a number of cases consisting, for example, of acute blockage of the interventricular foramina or the aqueduct by colloid cysts of the third ventricle (Buttner et al 1997;Shemie et al 1997;Aronica et al 1998), neoplasms (Shemie et al 1997), lipomas (Zappi et al 1993), pineal cysts (Milroy and Smith 1996;Mena et al 1997) or other causes such as sarcoidosis (Maisel and Lynam 1996), neurocysticercosis (Verma et al 1998), DandyWalker malformation (Elterman et al 1995) and arachnoid cysts (Norman et al 1995). These events are usually accompanied or preceded by neurological symptoms, most notably headaches, nausea or blurred vision.…”

Section: Introductionmentioning

confidence: 99%

Sudden unexpected death in young adults with chronic hydrocephalus

Rickert¹,

Grabellus

Varchmin-Schultheiß

et al. 2001

International Journal of Legal Medicine

View full text Add to dashboard Cite

We present four cases of sudden unexpected death in young adults with chronic hydrocephalus. The patients were between 20 and 28 years of age and had suffered from aqueduct stenosis (two patients), spina bifida in combination with Arnold-Chiari malformation (type II) and fragile X-syndrome. The patients suddenly collapsed with cardiorespiratory failure and could not be resuscitated and none had a history of headache or seizures. The post-mortem examinations revealed no unusual findings and a definite cause of death could not be established. Neuropathological examination revealed chronically hydrocephalic brains without any signs of uncal or tonsillar herniation. We hypothesise that a sudden pressure-induced decompensation of cerebral neuronal pathways involving insular and limbic cortex, hypothalamus and brain stem nuclei, may have caused disturbances of the cardiopulmonary control centres in the reticular formation of the brain stem, which in turn may have led to instantaneous cardiorespiratory arrest resulting in sudden "neurogenic" cardiac death.

show abstract

“…Case reports do exist, however, of sudden death due to obstructive hydrocephalus from such cysts 16,17 and their variable appearance on MRI 18 can make them indistinguishable from more sinister lesions. Longitudinal MRI follow up of incidental pineal cysts has usually shown either a stable appearance, or very slight change in size 19 and enlargement is often associated with a change in symptomatology.…”

Section: Discussionmentioning

confidence: 99%