A review of the pertinent literature regarding glial cysts of the pine
al region is presented. Various pathogenic factors have been advocated
such as the physiological involution of the pineal gland, a sequestra
tion of the embryonic cavum pineale or the degenerative evolution of g
lial inclusions within the pineal gland. The pathological description
is classical with three layers : an external fibrous capsule, an inter
mediate layer of pineal tissue and an internal glial wall. Imaging of
these lesions is typical, namely the thin rim of peripheral contrast e
nhancement and the presence of calcifications. These cysts are more fr
equent in women in their third decade of life. They are almost always
latent and their fortuitous disclosure at NMR examinations is common.
Some of them will nevertheless cause intracranial hypertension due to
hydrocephalus and hemorrhage. Those symptomatic cysts should be treate
d. Surgical excision has been the method of choice and the results are
good. More recently a mere stereotactic needle aspiration has been pe
rformed with satistactory long-term results.