Pineal epidermoid cysts: diagnosis and management

Object. The results of surgical treatment of epidermoid cysts of the pineal region in six cases are presented. Methods. Six patients with pineal epidermoid cysts underwent surgery at the Institute of Neurosurgery "N. N. Burdenko," in Moscow, during the period 1 976 to 1995. The duration of the patients' preadmission clinical history va ried from 6 months to 2 years (average 1.4 years). Headache, diplopia, and vertigo were the most frequently occurring symptoms. Neurological examinati on demonstrated papilledema, impaired pupillary reaction, ataxia, and long- pathways deficit; Parinaud's syndrome was found in only one case. Computeri zed tomography and magnetic resonance imaging constituted the primary diagn ostic tools. Surgery was performed using either an infratentorial-supracere bellar approach (two cases) or an occipital-transtentorial approach (four c ases). Conclusions. Surgical results can be excellent if a removal, as extensive a s possible, is performed using either the supracerebellar or occipital-tran stentorial approach.