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Treatment and Approaches for the Pineal Gland Region

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Pineal Neurosurgery

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Abstract

The key for successful treatment starts with correct diagnosis. These lesions have no pathognomonic features on neuroimaging. The surgery for pineal region tumors is necessary to obtain a tissue diagnosis as many diverse tumors could arise in this region, benign or malignant and sometimes vascular lesions. The surgical approaches for pineal lesion have evolved, becoming safer and more efficient with the use of microneurosurgery and neuroendoscopy which helped to decrease the mortality and morbidity of surgery. The choice of surgical approach must be based on surgeon’s preference as well as the patient’s anatomy. The two most commonly utilized surgical approaches are infratentorial-supracerebellar (ITSC) and occipital transtentorial (OTT) approach.

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Notes

  1. 1.

    The supracerebellar-infratentorial (SCIT) routes were popularized by Bennett M. Stein in 1971, when he reported six cases of this approach in sitting position under microscope with no perioperative mortality and little morbidity [10].

  2. 2.

    Gross total resections of 23 lesions were done by Hernesniemi et al. using the paramedian supracerebellar approach [22]. This approach was introduced by Yasargil for the management of aneurysms of the superior cerebellar artery [22, 23], Van den Bergh first described this approach for pineal tumors [22, 24].

  3. 3.

    Occipital transtentorial (OTT) approach was described by Heppner in 1959, popularized by Poppen in 1960 [20] and then modified by Jamieson in 1971 and later by Lapras (Capdeville 1974) [21].

  4. 4.

    Fukishima et al. were the first who described the usefulness of in the endoscope for biopsy in the pineal region [11], and then in 1997 Rohbinson and Cohen who firstly described endoscopic ventriculostomy and biopsy as an alternative to the ventriculoperitoneal shunts and performing a separate biopsy [13].

  5. 5.

    Purely endoscopic was done first Ruge et al. for fenestration of quadrigeminal region Arachnoid cysts [33, 34] in 1997, then to resects a pineal cyst [29, 32] in 2008, then applied to remove the tumors [36,37,32].

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

    Baha’eddin A. Muhsen & Hamid Borghei-Razavi

  2. Neurosurgery Teaching Hospital, Baghdad, Iraq

    Samer S. Hoz

Authors
  1. Baha’eddin A. Muhsen
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  2. Hamid Borghei-Razavi
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  3. Samer S. Hoz
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Corresponding author

Correspondence to Baha’eddin A. Muhsen .

Editor information

Editors and Affiliations

  1. Neurosurgery Teaching Hospital, Baghdad, Iraq

    Samer S. Hoz

  2. University of Al-Qadisiyah, College of Medicine, Department of Surgery, Diwaniyah, Iraq

    Ali A. Dolachee

  3. Neurosurgery Teaching Hospital, Baghdad, Iraq

    Hayder R. Salih

  4. University of Louisville, Department of Neurological Surgery, Louisville, KY, USA

    Zaid S. Aljuboori

  5. South West Deanery, Department of Neurosurgery, Plymouth, UK

    Wisam D. Selbi

  6. Ludmillenstift Hospital, Department of Neurosurgery & Spine Surgery, Meppen, Germany

    Giath Al-Dayri

  7. Ludmillenstift Hospital, Department of Neurosurgery & Spine Surgery, Meppen, Germany

    Mohammed Maan Al-Salihi

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Muhsen, B.A., Borghei-Razavi, H., Hoz, S.S. (2020). Treatment and Approaches for the Pineal Gland Region. In: Hoz, S.S., et al. Pineal Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-53191-1_7

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