Spontaneous involution of a large pineal region hemorrhagic cyst in an infant

Nimmagadda, Anitha; Sandberg, David I.; Ragheb, John

doi:10.3171/ped.2006.104.4.275

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…Most patients with pineal apoplexy have been reported to have relatively severe symptoms that often accompany acute occlusive hydrocephalus (4-6) and may occasionally result in sudden death (11) or the need for surgical treatment. In contrast, there have been few reports of patients with asymptomatic intracystic hemorrhage (7) or spontaneous resolution of hemorrhagic pineal cysts (4,12,13).…”

Section: Discussionmentioning

confidence: 99%

A Hemorrhagic Pineal Cyst with a Bacterial Meningitis-like Manifestation and Benign Outcome

et al. 2013

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Pineal cysts are a common incidental finding in imaging studies, and the majority of such cysts are asymptomatic. However, hemorrhaging pineal cysts, which are considered to be rare, are often associated with severe symptoms. We herein describe the case of a 58-year-old patient with the novel manifestation of a bleeding pineal cyst, who had a benign outcome without any surgical treatment. Although the clinical manifestations resembled those of bacterial meningitis, magnetic resonance images suggested chemical meningitis caused by an intracystic hemorrhage and rupture of the pineal cyst.

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Section: Discussionmentioning

confidence: 99%

A Hemorrhagic Pineal Cyst with a Bacterial Meningitis-like Manifestation and Benign Outcome

et al. 2013

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“…Although it is possible that these cysts have a worse long-term prognosis, it is also possible that the expected spontaneous resolution of the hemorrhage would lead to a corresponding improvement or resolution of symptoms. 45 Evidence of hemorrhage on MR imaging would not, by itself, be an indication for surgical treatment of an otherwise typical-appearing cyst in our practice. We reserve surgical treatment for cysts in patients who present with hydrocephalus or severe symptoms from mass effect of the hemorrhage.…”

Section: Mamourian and Towfighimentioning

confidence: 99%

Prevalence and natural history of pineal cysts in adults

Al-Holou¹,

Terman²,

Kilburg³

et al. 2011

JNS

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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.

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“…Existing literature that describe management of these lesions utilize various methods from observation, craniotomy for resection or fenestration, and endoscopic techniques [Table 1]. [7,13,16,18,[20][21][22] Even patient selection can be complicated. While almost all patients reviewed here do have headache, they all had additional signs or symptoms as well.…”

Section: Discussionmentioning

confidence: 99%

“…A Supplementary Video 1 is provided as well. [16] 12/F HA, syncope Drainage, ETV, craniotomy total excision Yes Asymptomatic Nimmagadda et al, 2006 [21] 10D/F Macrocephaly Observation Yes Asymptomatic Majeed and Enam, 2007 [13] 10/F HA, gaze palsy Ventriculoperitoneal shunt, craniotomy, total excision Yes Asymptomatic Sarikaya-Seiwert et al, 2009 [22] 16/F HA, papilledema Craniotomy, total excision Yes Asymptomatic 16/F HA, impaired concentration Craniotomy, total excision Yes Asymptomatic Davidson, 2020 [6] 3 [Figures 1a and b] revealed moderately dilated third and lateral ventricles and a 1.5 cm pineal region mass.…”

Section: Methodsmentioning

confidence: 99%

Exclusively endoscopic management of complicated pineal cysts in young children: Definitive treatment through single burr-hole technique

Hanna

Robinson

Skoch

2022

Surgical Neurology International

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Background: The management of complicated symptomatic pineal cysts in the pediatric population is challenging and variable. Surgical management may include treatment of hydrocephalus alone, or direct treatment of the cyst with or without direct hydrocephalus management. This is typically done through craniotomy-based microsurgical approaches to the pineal region or an endoscopic transventricular approach. Methods: We present a stepwise minimally invasive technique to treat complicated pineal cysts in young children associated with an obstructive hydrocephalus in a single procedure through third ventriculostomy combined with an intraventricular marsupialization of the pineal cyst through a single burr-hole using stereotactic navigation. Results: Two young patients with over 2 years of follow-up have done well without complication using this technique. Other literature reports for complex pineal cysts in pediatric patients are reviewed and this technique is not previously described for this population. Conclusion: Endoscopic third ventriculostomy and cyst marsupialization using a single burr-hole and stereotactic navigation for symptomatic or enlarging pineal cysts in children allow for minimally invasive management, a rapid recovery, short hospital stay, and durable outcome owed to redundant CSF flow pathways.

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Spontaneous involution of a large pineal region hemorrhagic cyst in an infant

Abstract: The authors report the case of a newborn presenting at birth with macrocephaly and a large pineal region hemorrhagic cyst without neurological deficit. No neurosurgical intervention was performed, and subsequent imaging studies demonstrated complete involution of the cyst.

Cited by 8 publications

References 12 publications

A Hemorrhagic Pineal Cyst with a Bacterial Meningitis-like Manifestation and Benign Outcome

A Hemorrhagic Pineal Cyst with a Bacterial Meningitis-like Manifestation and Benign Outcome

Prevalence and natural history of pineal cysts in adults

Exclusively endoscopic management of complicated pineal cysts in young children: Definitive treatment through single burr-hole technique

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