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Pineal cyst management: A single-institution experience spanning two decades
Alexander Konovalov1, David Pitskhelauri1, Natalia Serova2
1Department of Neurosurgery, Burdenko Neurosurgery Center, Moscow, Russian Federation.
Surgical Neurology International
|September 21, 2022
Summary
Pineal cysts (PCs) are often stable, but surgery can relieve headaches in symptomatic patients. However, surgery carries risks of neuro-ophthalmological complications, and PC growth factors remain unclear.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Pineal cysts (PCs) are common benign intracranial lesions.
- Management consensus is lacking, particularly for symptomatic nonhydrocephalic cysts.
Purpose of the Study:
- To analyze clinical outcomes for patients with pineal cysts, comparing surgical and conservative management.
- To evaluate the natural course and predictors of growth for pineal cysts.
Main Methods:
- Retrospective analysis of 142 patients with pineal cysts (103 surgical, 39 conservative).
- Data included clinical presentation, imaging, ophthalmological status, and outcomes.
Main Results:
- Headache resolved or improved in 91% of surgically treated patients.
- Postoperative complications included neuro-ophthalmological disorders (23%), often resolving long-term.
- Pineal cyst size remained stable in 87% of conservatively managed patients; age/gender did not predict growth.
Conclusions:
- Most newly diagnosed pineal cysts are stable.
- Surgery offers significant headache relief for nonhydrocephalic PCs but poses risks of neuro-ophthalmological issues.
- The natural history and growth factors of pineal cysts require further investigation.
