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Pineal Cyst or Pineal Gland Cyst: Causes, Signs, Symptoms, Diagnosis

What is Pineal Cyst or Pineal Gland Cyst?

Pineal cyst or pineal gland cysts are non-cancerous sacs filled with fluid, and exist at the pineal gland area in the brain. Small pineal cysts are 5mm or less in size, and occur commonly by chance during neurological exams. The pineal cyst or pineal gland cyst hardly cause any sign.

Larger pineal cyst or pineal gland cysts are seldom found but cause different symptoms. These symptoms include: headaches, singular vision and high pressure on the brain due to immoderate cerebrospinal fluid accumulation, which is also known as hydrocephalus. Severe convulsion and loss of awareness may be caused by large pineal cyst or pineal gland cysts that are symptomatic. However, the causes of pineal cyst or pineal gland cyst that are symptomatic are undiscovered.

What is a Pineal Cyst or Pineal Gland Cyst in the Brain?

What is a Pineal Cyst or Pineal Gland Cyst in the Brain?

It is an endocrine system gland, which is small and found in the brain. A pineal cyst or pineal gland cyst is also a benign cyst located in the pineal gland. According to history, the bodies are fluid-filled and have 1 to 4 percent appearance on MRI or magnetic resonance imaging brain scans. In addition, they are more frequent on death and have 21 to 41 percent appearance on autopsies.

What Does It Mean When a Pineal Cyst or Pineal Gland Cyst is an “Incidental Finding”?

It means the pineal cyst or pineal gland cyst is not likely to cause any symptoms, and not related to what was being checked in the brain scan by a doctor.

Causes of Pineal Cyst or Pineal Gland Cyst

The primary cause of large pineal cyst or pineal gland cyst is undiscovered. However, there is a theory that proposes that large pineal cyst or pineal gland cyst growth in young women is contributed by hormone influences during pregnancy or menstruation.

The other theory suggests that sequential growth of pineal cyst or pineal gland cyst is triggered by bleeding in the pineal area. An existing pineal cyst or pineal gland cyst might grow and turn to be asymptomatic due to hemorrhaging in the pineal area. A medical report literature records a symptomatic pineal cyst that advanced to secondary stage, due to bleeding in the pineal area.

The compression surrounding structures by a cyst causes the occurrence of large pineal cyst or pineal gland cyst. The compression of aqueduct of sylvius which is a structure that facilitates the passage of excess cerebrospinal fluid causes hydrocephalus. In case the quadrigeminal plate is compressed, parinaud’s syndrome occurs.

In other instances, choroids plexus cells have been noticed in the pineal cyst or pineal gland cyst wall linings. It is believed the cells are part of ionic fluxes process, which cause enlargement of pineal cysts by attracting water though semi permeable membranes.

Signs and Symptoms of Pineal Cyst or Pineal Gland Cyst

Headaches are the primary signs and symptoms linked to symptomatic pineal cyst or pineal gland cyst. The headaches might occur in three forms; chronic, unsteady headaches; short term, repetitive and gradual headaches, or persistent headaches. The symptoms of pineal cyst or pineal gland cyst occur after hydrocephalus or due to compression of particular structures in the brain, around the pineal area.

Hydrocephalus condition is characterized by pressure increase in the brain as a result of excessive cerebrospinal fluid accumulation in the skull. Hydrocephalus symptoms include: headaches, vomiting, nausea, convulsions, lethargy and papilledema, a condition in which the optic disks accumulates excessive amounts of watery fluid.

Those affected might have other different symptoms prior to compression of structures around the pineal area of the brain. The symptoms includes: diplopia which is double vision, blurred vision, dizziness, ataxia which is inability to coordinate voluntary movements and parinaud’s syndrome.

Rarely, some additional symptoms might occur. These include; syncope which is loss of consciousness, change in mental status and bleeding in to the pineal cyst or pineal gland cyst which is known as pineal apoplexy. Pineal apoplexy has caused four deaths of persons with symptomatic pineal cyst or pineal gland cyst. Some cases of green sexual growth in children are linked to pineal cysts.

The following disorders have symptoms that are similar to symptomatic pineal cyst or pineal gland cyst symptoms. However, comparison is useful for a differential diagnosis:

Tumors in the Pineal Region

Different tumors affecting the pineal gland have been recognized. These include: teratomas, germinomas, pineocytomas, gliomas, pinoeblastomas and choriocarcinomas. Symptomatic pineal cyst or pineal gland cyst causes the pineal region tumors to compress structures around, leading to different symptoms such as ;headaches, nausea, vision abnormalities, vomiting and a rise in pressure in the brain due to cerebrospinal fluid accumulation in excess. Other pineal tumors appear as pineal cyst or pineal gland cyst, making them hard to distinguish from large pineal cyst or pineal gland cyst while examining affected tissues with a microscope.

Tests to Diagnose Pineal Cyst or Pineal Gland Cyst

Symptomatic pineal cyst or pineal gland cyst diagnosis can be imagined after a detailed clinical evaluation, history of the patient, recognition of typical symptoms and the results from specific studies, mainly CT scan and MRI.

  • Computerized (or computed) tomography scan to diagnose pineal cyst or pineal gland cyst: While performing a CT scan, a film is created to show the cross-sectional images of the brain structure by the use of a computer and X-rays.
  • Magnetic resonance imaging for diagnosing pineal cyst or pineal gland cyst: While using MRI, cross-section images of the brain are formed by the use of magnetic field and radio waves.

It is important to differentiate symptomatic pineal cyst or pineal gland cyst from pineal tumors, as some pineal tumors appear as pineal cyst or pineal gland cyst, making it hard to distinguish them from pineal cyst or pineal gland cyst without the use of a microscope while examining the affected tissues.

References:

  1. Hakyemez, B., Erdogan, C., Yildirim, N., Kocaeli, H., & Korfali, E. (2008). Pineal gland cysts: A radiological evaluation. Clinical Imaging, 32(3), 173-178. DOI: 10.1016/j.clinimag.2007.11.005
  2. Francel, P., Isolan, G. R., Sufka, R. A., Quintero-Prigione, C., Kienstra, M. A., Chadduck, W. M., & van Loveren, H. (2001). Surgical management of pineal region tumors: 25 years of experience. Journal of Neurosurgery, 95(6), 903-910. DOI: 10.3171/jns.2001.95.6.0903
  3. Wang, W., & Lin, Z. (2019). Pineal apoplexy associated with cystic pineal tumors. Turkish Neurosurgery, 29(2), 288-292. DOI: 10.5137/1019-5149.JTN.21351-17.2
  4. Frazier, J. L., Lee, H., Tihan, T., & Wiemels, J. (2009). Pineal region tumors in children. Journal of Neurosurgery: Pediatrics, 3(2), 110-116. DOI: 10.3171/2008.9.PEDS08147
  5. Laun, A. S., Schwartz, D. L., Shah, R., Hellman, R. S., & Schaefer, P. W. (2013). Radiation-induced cystic change in pineal parenchymal tumors. Journal of Neuroimaging, 23(4), 510-513. DOI: 10.1111/j.1552-6569.2012.00730.x

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 31, 2023

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