Comment on - "Pineal cysts without hydrocephalus: microsurgical resection via an infratentorial-supracerebellar approach-surgical strategies, complications, and their avoidance".

Pineal cysts without hydrocephalus present a clinical dilemma, as surgical indications remain controversial. This study evaluates 73 patients who underwent microsurgical resection of pineal cysts via an infratentorial-supracerebellar (SCIT) approach, focusing on surgical strategies, complications, and outcomes. With a follow-up period averaging 26.6 months, 89% of patients reported significant symptom improvement, particularly in headache, visual disturbances, and dizziness. Total cyst resection was achieved in 95% of cases, with minimal complications. The findings suggest that microsurgical resection can provide marked relief in carefully selected patients, even in the absence of ventriculomegaly. Future studies should focus on randomized comparisons between surgical and conservative approaches and explore long-term outcomes.