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Pineal Gland Cysts

Pineal Gland CystsPineal Gland CystsPineal Gland Cysts

Awareness Today & Answers Tomorrow

Awareness Today & Answers TomorrowAwareness Today & Answers TomorrowAwareness Today & Answers Tomorrow

Frequently Asked Questions

A Pineal Gland Cyst is a fluid-filled sac located in the Pineal Gland, a small-cone shaped structure in the center of the brain.  The exact cause of Pineal Gland Cysts are unknown, but they are thought to be related to: Developmental abnormalities, Inflammation, and Trauma.  There is no medicine that you can take for treatment of a Pineal Gland Cyst, but there are medications you can take to help navigate through the symptoms that arise as a result.


Pineal Gland Cysts are generally not dangerous because most are small, asymptomatic, and benign.  However, large cysts cor those that cause bleeding into the cyst (Pineal Apoplexy) can be dangerous and cause serious neurological symptoms, including headaches, seizures, and vision problems.  In rare instances, a large cyst can also lead to Hydrocephalus (fluid buildup) or compression of brain structures, requiring medical attention and potential surgery.


  • Mass Effect: Large cysts can press on surrounding brain structures, leading to symptoms like headaches, nausea, vision problems (especially difficulty looking up), and confusion.
  • Hydrocephalus: A cyst can block the flow of cerebrospinal fluid (CSF), causing it to build up and increase pressure in the brain, leading to symptoms like vertigo, difficulty walking, and further neurological issues.
  • Intracystic Hemorrhage (Pineal Apoplexy): In rare cases, there can be bleeding into the cyst, which can cause sudden onset of symptoms such as severe headache and vomiting.
  • Exacerbation by Exertion: In very rare and extreme cases, physical exertion can worsen the compression on the brain-stem, potentially leading to sudden death.


  • Asymptomatic and Small: The vast majority of Pineal Gland Cysts are found incidentally during brain scans for other reasons and do not cause any symptoms.
  • Benign Nature: These cysts are non-cancerous fluid-filled sacs and are not inherently harmful.
  • Stable Over Time: For many individuals the size of the cyst remains stable over time, and they may not require long-term follow-up,


A Pineal Gland Cyst is a sac or pouch filled with fluid or air.  A pineocytoma is a tumor, or mass of abnormal cells.  Pineal Gland Cysts rarely grow while pineocytomas do grow, although very slowly.  Pineal Gland Cysts and Pineocytomas are both benign (non-cancerous).


A Pineal Gland Cyst doesn't require removal unless it's causing symptoms like hydrocephalus, frequent headaches/migraines, or neurological issues, in which case a neurosurgeon can perform a less invasive endoscopic or microsurgical removal.  In some cases, the neurosurgeon may place a shunt to drain fluid rather than remove the cyst.  Technology like 3D brain mapping, exoscopes, and neuro-navigation helps neurosurgeons visualize and operate with greater precision, leading to smaller incisions and feaster recovery times.


Flying commercially is relatively safe if the Pineal Gland Cyst is small and unlikely to cause symptoms.  However, you should always consult with your doctor for questions specific to your diagnosis.


Craniotomy: This traditional open surgery involves making a small opening in the skull to directly access and remove or drain the cyst, often used for larger or less accessible cysts.

  • Microsurgical Craniotomy (Open Surgery): Modern versions of this approach may use neuro-navigation and exoscopes for enhanced visualization and precision.



Endoscopic Surgery: A less invasive approach where a neurosurgeon uses an endoscopic and other specialized tools to access the cyst through existing openings, such as the nostrils.

  • Endoscopic Third Ventriculostomy (ETV): This technique can be used to address hydrocephalus by creating a new pathway for cerebrospinal fluid, sometimes performed alongside cyst treatment.
  • Transsphenoidal Endoscopy: This specific endoscopic approach involves going through the nose to access the cyst.
  • Posterior Fossa Endoscopy: This technique is performed by making a small incision at the back of the head, allowing access above the cerebellum.


Exoscope-Assisted Surgery: A technique that uses a "Synaptive Exoscope" to provide magnified, high-resolution 3D view of t he surgical site on a larger screen.  It improves visualization, reduces the need for repositioning the equipment, and allows for better coordination with surgical staff.  It can be used in both open and minimally invasive approaches to increase precision.


Brain surgery to remove a Pineal Gland Cyst can range in length, with some endoscopic procedures taking as little as 30 minutes to an hour, while more complex craniotomies for larger or more complicated cysts can last between two and four hours or even longer.  The exact duration depends on the size and location of the cyst, the type of surgical approach used, and other factors such as setup time and monitoring.


"It's a fairly risky procedure because these cysts are deep in the center of the brain.  Not everyone is trained in how to approach this type of excision, and not everybody is comfortable performing this surgical approach." by Sunil Patel, M.D.


 A Pineal Gland Cyst will rarely, but potentially, kill you. Most Pineal Gland Cysts are benign, asymptomatic, and found incidentally during  imaging, but in rare cases, they can grow large and compress essential  brain structures like the brainstem. This compression can lead to serious neurological symptoms or, in some cases, sudden death due to disruption of vital respiratory and cardiovascular functions.  The following issues could increase fatality risk on larger cysts:

  • Midbrain compression
  • Hydrocephalus
  • Bleeding 
  • Physical exertion



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