Vascular Lesions of the Pineal Region: A Comprehensive Review of the Therapeutic Options

World Neurosurg. 2022 Mar:159:298-313. doi: 10.1016/j.wneu.2021.09.061.

Abstract

Objective: Vascular lesions of the pineal region comprise aneurysms of the pineal region, arteriovenous malformations, cavernous malformations, and vein of Galen malformations. In the present report, we have offered an extensive review of each vascular pineal region lesion.

Methods: We performed an extensive literature review, focusing on the current therapeutic options available for the different vascular lesions of the pineal region.

Results: Vascular lesions of the pineal region are rare. Microneurosurgery remains a valid treatment of cavernomas, arteriovenous malformations, and aneurysms. Endovascular treatments seem to be the first option for the vein of Galen malformations, followed by microneurosurgery. Radiosurgery seems beneficial for small-size arteriovenous malformations. Complex and large vascular lesions will require a combination of multiple treatments.

Conclusions: Vascular lesions of the pineal region are complex, uncommon diseases. Thus, definitive therapeutic modalities for these lesions require further research.

Keywords: Pineal aneurysms; Pineal arteriovenous malformations; Pineal cavernomas; Pineal region.

Publication types

  • Review

MeSH terms

  • Arteriovenous Malformations* / surgery
  • Humans
  • Intracranial Arteriovenous Malformations* / surgery
  • Pineal Gland* / blood supply
  • Pineal Gland* / surgery
  • Radiosurgery*
  • Vein of Galen Malformations* / surgery