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Natural Progression of Pineal Cysts in Relation to Headache: A Prospective Observational Study.

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Title: Natural Progression of Pineal Cysts in Relation to Headache: A Prospective Observational Study.
Authors: Hvingelby, Victor (AUTHOR), Tsigka, Eirini (AUTHOR), Jensen, Rigmor Hoejland (AUTHOR), Hylin, Sofia (AUTHOR), Mathiesen, Tiit (AUTHOR)
Source: European Journal of Neurology. Mar2025, Vol. 32 Issue 3, p1-9. 9p.
Subjects: Headache, Pineal gland, Cysts (Pathology), Disease progression, Melatonin, Neurosurgery, Cohort analysis, Diagnostic imaging
Abstract: Background: Pineal cysts are a frequent, potentially incidental finding in routine imaging studies. Their relationship with headache has been a matter of some controversy. In this prospective observational study, we sought to track the clinical and radiological trajectory of pineal cysts in both patients with and without concurrent headache. Methods: A cohort study was conducted in patients referred to the Department of Neurosurgery at Karolinska Hospital for evaluation of a pineal cyst ≥ 5 mm between June 2005 and April 2017. Patients were stratified according to headache status and classified according to standard criteria. Development in cyst size and degree of aqueduct stenosis, as well as clinical progression of headache, was tracked. Results: 157 cysts were identified (50 males and 107 females, mean age: 37 years), 103 of which were in patients primarily assessed for headaches. Cyst size remained stable over the follow‐up period. There was no relationship between cyst size, the presence or progression of headache, nor with amenability to treatment. No relationship between the mass effect of the quadrigeminal plate and headache was observed. Of 13 patients treated with melatonin, 7 (53%) reported a subsequent decrease in headache severity. Conclusions: A major proportion of seemingly incidental pineal cysts referred for neurosurgical evaluation were detected during work‐up for headache. Furthermore, the size and symptoms associated with cysts remain stable over time, barring intervention. The therapeutic implications and relationship with other factors such as melatonin remain to be explored. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
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  Data: Natural Progression of Pineal Cysts in Relation to Headache: A Prospective Observational Study.
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  Data: <searchLink fieldCode="AR" term="%22Hvingelby%2C+Victor%22">Hvingelby, Victor</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tsigka%2C+Eirini%22">Tsigka, Eirini</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jensen%2C+Rigmor+Hoejland%22">Jensen, Rigmor Hoejland</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hylin%2C+Sofia%22">Hylin, Sofia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mathiesen%2C+Tiit%22">Mathiesen, Tiit</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Mar2025, Vol. 32 Issue 3, p1-9. 9p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Headache%22">Headache</searchLink><br /><searchLink fieldCode="DE" term="%22Pineal+gland%22">Pineal gland</searchLink><br /><searchLink fieldCode="DE" term="%22Cysts+%28Pathology%29%22">Cysts (Pathology)</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+progression%22">Disease progression</searchLink><br /><searchLink fieldCode="DE" term="%22Melatonin%22">Melatonin</searchLink><br /><searchLink fieldCode="DE" term="%22Neurosurgery%22">Neurosurgery</searchLink><br /><searchLink fieldCode="DE" term="%22Cohort+analysis%22">Cohort analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnostic+imaging%22">Diagnostic imaging</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Pineal cysts are a frequent, potentially incidental finding in routine imaging studies. Their relationship with headache has been a matter of some controversy. In this prospective observational study, we sought to track the clinical and radiological trajectory of pineal cysts in both patients with and without concurrent headache. Methods: A cohort study was conducted in patients referred to the Department of Neurosurgery at Karolinska Hospital for evaluation of a pineal cyst ≥ 5 mm between June 2005 and April 2017. Patients were stratified according to headache status and classified according to standard criteria. Development in cyst size and degree of aqueduct stenosis, as well as clinical progression of headache, was tracked. Results: 157 cysts were identified (50 males and 107 females, mean age: 37 years), 103 of which were in patients primarily assessed for headaches. Cyst size remained stable over the follow‐up period. There was no relationship between cyst size, the presence or progression of headache, nor with amenability to treatment. No relationship between the mass effect of the quadrigeminal plate and headache was observed. Of 13 patients treated with melatonin, 7 (53%) reported a subsequent decrease in headache severity. Conclusions: A major proportion of seemingly incidental pineal cysts referred for neurosurgical evaluation were detected during work‐up for headache. Furthermore, the size and symptoms associated with cysts remain stable over time, barring intervention. The therapeutic implications and relationship with other factors such as melatonin remain to be explored. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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        Value: 10.1111/ene.70120
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        Text: English
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        PageCount: 9
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    Subjects:
      – SubjectFull: Headache
        Type: general
      – SubjectFull: Pineal gland
        Type: general
      – SubjectFull: Cysts (Pathology)
        Type: general
      – SubjectFull: Disease progression
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      – SubjectFull: Melatonin
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      – SubjectFull: Neurosurgery
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      – SubjectFull: Cohort analysis
        Type: general
      – SubjectFull: Diagnostic imaging
        Type: general
    Titles:
      – TitleFull: Natural Progression of Pineal Cysts in Relation to Headache: A Prospective Observational Study.
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            NameFull: Hvingelby, Victor
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              M: 03
              Text: Mar2025
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              Y: 2025
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