Pineal gland is a reddish-gray body about the size of a pea. It is an endocrine gland, shaped like a tiny pine cone and located close to the center of the brain, between the two hemispheres. Pineal gland produces melatonin.
Different pineal gland lesions may occur and they could be divided into
• Germ cell tumors
• Pineal parenchymal tumors
Pineal cysts are found in only 1-4% cases on MRI imagine while 21%-41% can be seen on autopsies. Although these cysts could appear in all ages, they are most likely to occur in the fourth decade. They are more common in women than in men, especially young women, ages 20-30. This suggests that hormones may play a role. In women, the cysts increase with age and then disappear while in men, they tend to stay stable over time.
Researchers showed that 10% of cysts would increase, 75% remain the same and the rest would shrink.
Most of the time, pineal cysts are asymptomatic. If this is the case, they require no treatment. Some doctors choose to monitor patients with CT scans or MRI to look for cyst growth while others do not. If the cysts do cause symptoms, they are headaches (by disrupting the flow of blood through the area) , visual disturbances (compress the tectal plate), or hydrocephalus (by causing an obstruction to the cerebral acueduct). Hydrocephalus is an accumulation of cerebrospinal fluid (CSF) in the ventricles, or cavities, of the brain that occurs if the cysts that may lead to increased intracranial pressure inside the skull and progressive enlargement of the head, convulsion, and mental disability if left untreated. In rare cases, large symptomatic pineal cysts may seizures or loss of consciousness.
Pineal cysts are not cancer and most of the time they do not enlarge over 2 cm.
However, if successive MR images show the cyst growth or a progression of the clinical symptoms, surgery may be indicated. Many people that have been found the cysts and were symptomatic report relief of symptoms after the surgery.
It is very likely that talking to your doctor about the symptoms may cause disbelief and blank stares but you need to be persistent in finding a neurologist, neuro-ophthalmologist or a neurosurgeon that would address your problem correctly and accept it as existent.
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