The pineal gland is a small, pine-shaped structure in the brain that produces melatonin, a hormone which helps regulate sleep patterns. This gland grow in size up to the age of two, after which the size stabilizes but increases in weight after puberty.
Benign (non-cancerous) new growths in the pineal region are called pineal cysts. These are often seen as incidental findings in the radiographic tests such as MRIs (magnetic resonance imaging). Previous studies have shown that pineal cysts are found in 5-10% of brain MRIs in healthy adults. However, a recent study using high resolution MRI showed that it can occur in more than 20% of healthy individuals. An even higher percentage is found as incidental finding at autopsies (up to 40%). They are commonly found in adults between the ages of 20 to 30. Although some studies show that these cysts are more common in females (3:1), other studies show that there is no difference in occurrence between men and women. They are also commonly found in young children. A recent study showed that pineal cysts tend to grow in size in younger children and remain stable in size in older children. The cause of pineal cysts is unknown.
Symptoms of Pineal Cysts
Pineal cysts are often small, fluid-filled sacs measuring about one centimeter or less in diameter. They usually cause no symptoms are just found incidentally during examinations for other reasons. However, larger pineal cysts such as those bigger than 15 millimeters are usually associated with symptoms. These symptoms include headaches, dizziness (vertigo), and abnormalities in vision. These bigger cysts may also be associated with increased intracranial pressure, because they can cause a build-up of cerebrospinal fluid in the brain when they exert pressure on the surrounding blood vessels. These can lead to vomiting, one-sided weakness, seizures, slowing of heart rate and loss of consciousness. Bleeding from the cyst has also been reported, which resulted in sudden death.
Treatment of Pineal Gland Tumors
Finding pineal cysts in routine neurologic or radiographic tests may be scary, but if they are small and not associated with any symptom, you should not be too concerned.
Although most pineal cysts are harmless, it is important to distinguish them from other tumors that are found in the brain during examinations, since treatments may differ for other tumors. Most doctors agree, however, that no further workup or treatments are necessary for small pineal cysts that produce no symptoms. For tumors that are large and symptomatic, surgery may be needed to relieve the pressure inside the brain.
On the other hand, malignant or cancerous tumors of the pineal gland are rare. They make up about 1% of brain tumors in adults and about 3% to 8% of brain tumors in children. These are found in children around the age of 13 and in adults around the age of 30. Treatment options include chemotherapy, radiotherapy and radiosurgery.
If you have chronic or progressive symptoms of headaches, vertigo, weakness, vision problems, seizures, and loss of consciousness, consult a doctor to obtain proper diagnosis and treatment of your condition.
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