Pineal Region Tumors Surgery India, Low Price Pineal Region Tumors Surgery

Neurosurgery

Pineal Region Tumors

The pineal gland develops during the second month of gestation as a diverticulum in the diencephalic roof of the third ventricle. It is flanked by the posterior and habenular commissures in the rostral portion of the midbrain directly below the splenium of the corpus callosum. The velum interpositum is found rostral and dorsal to the pineal gland and contains the internal cerebral veins, which join to form the vein of Galen.

Pineal region tumors are derived from cells located in and around the pineal gland. The principle cell of the pineal gland is the pineal parenchymal cell or pinocyte. This cell is a specialized neuron related to retinal rods and cones. The pinocyte is surrounded by a stroma of fibrillary astrocytes, which interact with adjoining blood vessels to form part of the blood-pial barrier.

Symptoms

Regardless of the type of tumor involved, tumors in the pineal region usually cause symptoms through one of three mechanisms. They can increase pressure in the skull by blocking the flow of cerebrospinal fluid (hydrocephalus), they can compress part of the brain, or they can cause disruptions in the endocrine system, the system that controls hormones and includes the pineal gland. Hydrocephalus is a common result of tumors in this region, and will lead first to headaches, and then perhaps to nausea, vomiting, and altered mental status. The brainstem and the cerebellum are the most common sites of compression from a pineal region tumor; compression in these regions can cause abnormal eye movements (including Parinaud's syndrome, the inability to look up), double vision, uncoordinated body movements, or unsteady gait. Endocrine dysfunction is less common and usually is caused when the tumor involves the hypothalamus, a nearby brain region that is involved in growth and metabolism.

Diagnosis

As with other brain tumors, imaging studies are the key component in the diagnosis of pineal region masses. Magnetic resonance imaging (MRI) scans primarily are used. They can show the size and characteristics of the tumor, and can indicate the presence of hydrocephalus. Computed tomography (CT) scans, which can help detect the presence of calcification or hardening in the tumor, also are used.