Pineal lesions: clinical presentation, hormone secretion, sleep quality and effect of surgical treatment

Introduction: Pineal region is a deep-seated part of the brain surrounded by highly eloquent structures. Differential diagnosis of space-occupying lesions in this region encompasses pineal gland cysts, pineal gland tumours, metastases, germ cell tumours, meningiomas, gliomas, hemangioblastomas and neuroectodermal tumours. In this thesis, I focused mainly on patients with pineal cysts, which is a benign affection of the human pineal gland on the borderline between pathology and normality. The clinical management of patients with a pineal cyst remains controversial, especially when patients present with non-specific symptoms. A melatonin secretion in patients with a pineal cyst before and after a pineal cyst resection has not been studied yet and the effect of surgery on human metabolism is unknown. Materials and Methods: We performed a prospective study between 2000 and 2016. All patients with a pineal cyst larger than 7 mm were included. Epidemiological data, presenting symptoms, surgical results and radiographic and clinical follow-up were documented. We examined melatonin, cortisol and blood glucose secretion profiles perioperatively in a subgroup of 4 patients. The control group was represented by 3 asymptomatic patients with a pineal cyst. For each patient, 24-h circadian secretion curves of..