• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.899-903
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• 2000

Objective : Object : A 7-year retrospective clinical and MRI study was reviewed to evaluate the characteristics of pineal cyst. We evaluated results of clinical and radiologic change of pineal cyst during follow up period. Patients and Methods : From 1992 to 1999, 50 patients with pineal cyst were visited for evaluation. Follow up clinical information was obtained from patients or clinical record through phone conversation. also radiologic findi-ngs of pineal cyst in mid-sagittal MRI were reviewed in detail. Results : Pineal cysts were usually asymptomatic and detected incidentally during evaluation of other diseases. Sagittal MRI is the most useful diagnostic test. The radiologic findings of pineal cyst were isointensity on T1WI comared to CSF and slightly high signal intensity on T2WI. Cyst wall was variably enhanced on Gad-enhanced T1WI. The average size of cyst was $13.9{\times}13.0mm$. The pineal cyst was classified into five groups according to previous report. Long term behavior of these lesions are not apparent, but in our study they showed no specific changes in clinical and radiological aspects during 25 months. Conclusion : Although long-term follow up results are needed, the pineal cyst are considered as normal variants. In our 25 months follow up results, there was no rapid change of cyst both clinically and radiologically. Therefore, frequent radiologic evaluation seems unnecessary except type III pineal cyst.

• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.113-117
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• 2000

Objective : Asymptomatic cyst of the pineal gland is a common incidental finding in adults on computerized tomography or magnetic resonance image(MRI) or at postmortem examination. This study was conducted to identify MRI findings of the benign pineal cysts and to determine the proper management of asymptomatic pineal cysts. Methods : From January 1995 to March 1999, 13 cases of asymptomatic pineal cysts were diagnosed incidentally on MRI. The mean age of the patients at diagnosis was 43 years(ranged 8 to 69 years). Five patients were females and eight patients were males. We analyzed the clinical presentations and MRI findings. Results : Clincal features were not related to pineal cysts in all 13 cases included posttraumatic headache in seven cases, headache related to brain tumor in two cases, one of facial palsy, one of diabetic neuropathy, and two of other diseases. MRI demonstrated a well-demarcated mass lesion(mean 1.3cm in diameter) of low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Gadolinium-enhanced MRI, performed in 10 cases, demonstrated a rim enhancement. Hydrocephalus was not present in all cases. Follow-up MRI(ranged 12 to 36 months) obtained in 3 of the 13 patients showed stability of cyst size. After symptomatic treatment, presenting symptoms were resolved in all patients and symptom related to pineal cysts have not been developed during follow up period(mean 27 months). Conclusion : The long-term behavior of asymptomatic pineal cysts is still unknown. But we advocate conservative management of these benign pineal cysts that may be developmental variants of normal pineal gland.