Autonomic dysfunction in patients with tectal plate compression: A systematic review

Area of Science:

• Neurology
• Neurosurgery
• Systematic Reviews

Background:

• Pineal region lesions can compress the tectal plate, leading to hydrocephalus and symptoms like headaches and Parinaud's Syndrome.
• The relationship between pineal region lesions and autonomic nervous system dysfunction has not been previously studied.

Purpose of the Study:

• To evaluate the clinical presentation of pineal lesions causing tectal plate compression.
• To focus on the association between these lesions and autonomic dysfunction.

Main Methods:

• A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Included were case reports and studies (prospective and retrospective) of patients with pineal or tectal region lesions.

Main Results:

• 26 studies comprising 363 patients were analyzed.
• Headache (62.8%) and epileptic phenomena (20.9%) were common symptoms. Autonomic dysfunction symptoms (dizziness, nausea, pupillary dysfunction, photophobia, fatigue) were present in 69.1% of patients.
• Surgery improved or resolved symptoms in 67.5% of patients, including 120 patients with improved autonomic dysfunction.

Conclusions:

• Pineal region lesions are associated with significant autonomic dysfunction, not just hydrocephalus and Parinaud's Syndrome.
• Autonomic nervous system dysfunction should be considered in the initial presentation and treatment of patients with pineal region lesions.