Symptomatic pineal cysts

The authors described two clinical observations of non-tumourous pineal cysts in young women manifested by apathy, tottering gait and slight symptoms of intracranial hypertension in one woman and incomplete Parinaud's syndrome in the second woman. In both instances for the diagnosis the MRT finding of an ovoid cyst in the gl. pinealis was decisive as it compressed the aqueduct and caused three ventricular hydrocephalus. In both women the clinical manifestations improved after ventriculocisternal drainage as described by Torkildsen. Pineal cysts are found in 1 - 4 % of all conventional MRT examinations. Only one tenth is clinically manifested by symptoms caused by compression of the aqueduct, mid-brain or mesodiencephalic borderline. Final evidence of the benign nature of a glial pineal cyst is provided by stereotactic biopsy or long-term clinical follow-up with MRT checks, Surgery is indicated only in case of symptomatic pineal cysts.