Bosnjak Jelena, Budisić Mislav, Azman Drazen, Strineka Maja, Crnjaković Miljenko, Demarin Vida
University Department of Neurology, Reference Center for Neurovascular Disorders, Ministry of Health and Social Welfare of the Republic of Croatia, Sestre milosrdnice University Hospital, Zagreb, Croatia.
Acta Clin Croat. 2009 Sep;48(3):355-8.
Pineal cysts occur in all ages, predominantly in adults in the fourth decade of life. In series of magnetic resonance imaging (MRI) studies, the prevalence of pineal cysts ranged between 1.3% and 4.3% of patients examined for various neurologic reasons and up to 10.8% of asymptomatic healthy volunteers. The diagnosis of pineal cyst is usually established by MRI with defined radiological criteria to distinguish benign pineal cyst from tumors of this area. A recent study demonstrated the findings obtained by transcranial sonography to correspond to those obtained by MRI in the detection of both pineal gland cyst and pineal gland itself, and could be used in the future mainly as follow up examination. Pineal cysts usually have no clinical implications and remain asymptomatic for years. The most common symptoms include headache, vertigo, visual and oculomotor disturbances, and obstructive hydrocephalus. Less frequently, patients present with ataxia, motor and sensory impairment, mental and emotional disturbances, epilepsy, circadian rhythm disturbances, hypothalamic dysfunction of precocious puberty, and recently described occurrence of secondary parkinsonism. Symptomatic cysts vary in size from 7 mm to 45 mm, whereas asymptomatic cysts are usually less than 10 mm in diameter, although a relationship between the cyst size and the onset of symptoms has been proved to be irrelevant in many cases. There is agreement that surgical intervention should be undertaken in patients presenting with hydrocephalus, progression of neurologic symptoms, or cyst enlargement. Tissue sample of the pineal lesion can be obtained by open surgery, stereotaxy and neuroendoscopy.
松果体囊肿可发生于所有年龄段，主要见于40岁左右的成年人。在一系列磁共振成像（MRI）研究中，因各种神经原因接受检查的患者中，松果体囊肿的患病率在1.3%至4.3%之间，而在无症状的健康志愿者中，这一比例高达10.8%。松果体囊肿的诊断通常通过MRI并依据明确的放射学标准来确立，以区分良性松果体囊肿与该区域的肿瘤。最近一项研究表明，经颅超声检查在检测松果体囊肿和松果体本身时所获得的结果与MRI的结果相符，并且未来主要可用于随访检查。松果体囊肿通常无临床意义，多年来一直无症状。最常见的症状包括头痛、眩晕、视觉和动眼神经障碍以及梗阻性脑积水。较少见的情况是，患者出现共济失调、运动和感觉障碍、精神和情绪障碍、癫痫、昼夜节律紊乱、性早熟的下丘脑功能障碍，以及最近描述的继发性帕金森综合征。有症状的囊肿大小在7毫米至45毫米之间，而无症状的囊肿直径通常小于10毫米，尽管在许多情况下，囊肿大小与症状发作之间的关系已被证明并不相关。人们一致认为，对于出现脑积水、神经症状进展或囊肿增大的患者，应进行手术干预。松果体病变的组织样本可通过开放手术、立体定向手术和神经内镜检查获取。
