The pineal gland or pineal gland (pineal) - is a neuroendocrine gland located between the hemispheres of the brain and is part of the intermediate brain. The name received due to its oval shape. It weighs only 0.2 g and has dimensions of 1.5 cm x 1 cm.
Why is it considered neuroendocrine? Because it relates to both the brain and the endocrine system. This is expressed in the fact that it affects some processes in the body, and also produces hormones.
Outside the pineal gland is covered with a soft connective tissue membrane, from which the trabeculae depart and divide it into lobules. Lobules consist of their polygonal cells - pineocytes. Iron has a rich blood supply.
The functional significance of the gland
The value of the pineal gland is not fully understood, it is too small and deeply located. But the hormones that it produces are identified: melatonin, serotonin, pinealin, adrenoglomerulotropin, dimethyltryptamine.
Serotonin - is a precursor to melatonin and is involved in the regulation of circadian rhythms (sleep and wakefulness). 80% of melatonin is produced precisely in the pineal gland. Melatonin inhibits the development of the sex glands in children, affecting the gonadotropin hormone. Its development requires absolute darkness, otherwise its synthesis instantly ceases. Therefore, the formation of melatonin occurs during night sleep. With the end of puberty, production decreases.
The pineal gland in children affects the functioning of the entire endocrine system: the thyroid gland, adrenal glands and the pituitary gland. He not only participates in the regulation of sexual development, but also is a connecting element between the tissues of the cerebral cortex. In addition, the pineal gland reduces the production of STH, inhibits sexual behavior, the development of tumors, is responsible for orientation in space and time; regulates the exchange of Ca, P, K, magnesium; regulates seasonal rhythms; possesses antioxidant properties, showing antitumor protection, delays aging.
Serotonin is not only a precursor to melatonin, but is also considered a hormone of happiness, creates a good mood and improves the emotional background. Adrenoglomerulotropin - regulates the production of adrenal hormones, stimulates the production of aldosterone, thus participating in electrolyte metabolism.
Pinealine reduces blood sugar. Little studied.
Dimethyltryptamine (DMT) is responsible for dreams and clairvoyance, near death experiences.
For centuries, the pineal gland was considered the receptacle of the soul, in esotericism - the third eye, determining the ability to clairvoyance and transmit information at a distance - telepathy.
Apparently, this is due to the fact that the pineal gland itself can make rotational movements resembling the movements of the eyeball.
In addition, in the structure of the gland there are rudimentary elements like the lens and some receptors that resemble the eyeball, but they are underdeveloped.
The pineal gland in children is actively growing, but already from adolescence its growth is gradually decreasing. With age, she begins to involution and her activity decreases.
Pineal gland disease
As in any other organ, abnormalities of development, inflammation, parasite lesions, trauma, neoplasms, cysts, etc. are possible here. The cyst of the pineal region is rare - of the pathologies of the brain, it takes only 2%. But some researchers believe that the figure is greatly underestimated. There are many more cases, but it is difficult to identify them due to the lack of symptoms.
Reasons for the appearance of a cyst
What is a pineal cyst? A cyst is a cavity filled with a liquid substance and limited by a membrane.
True cyst - education is exclusively benign and does not degenerate into oncology. But neurosurgeons often encounter a parasitic cyst filled with echinococci.
Most often, such a cyst of the pineal region of the pineal gland is formed as a result of the flow of blood into the brain of echinococcus and other parasites. The larva infects the pineal gland, forms its own capsule, where the products of its vital activity accumulate.
Such a cyst is as toxic and dangerous as possible. The difficulty is that this capsule is completely protected from the immune system. A cyst of this origin tends to grow.
- Other reasons for the appearance of a pineal cyst include: narrowing or blockage of the outlet duct of the gland, in which melatonin begins to accumulate inside, gradually forming a cavity. Such changes are possible after inflammatory processes, embolus.
- Congenital malformations of the brain in embryogenesis.
- TBI, which can lead to degeneration and degeneration of brain tissue.
- A stroke, when a hematoma appears in the hemorrhage, passing into the cyst.
- Impaired blood circulation.
- Untreated infections.
The cyst of the pineal region in children is often congenital (with hypoxia of the brain, birth head injuries), or occurs after infections that occur immediately after birth.
Kinds
There are 5 types of cysts:
- arachnoid (the most frequent and most dangerous);
- colloidal;
- pineal;
- dermoid;
- epidermoid.
The arachnoid cyst of the pineal region or cerebrospinal fluid is localized in the arachnoid membranes of the brain filled with CSF. It is more often diagnosed in men, develops after inflammation, infections. It gives symptoms in case of increased intracranial pressure and compression of a portion of the cerebral cortex with its enhanced growth.
Colloidal cysts are usually congenital, do not manifest themselves for a long time. With violations of cerebrospinal fluid dynamics can cause the development of intracerebral hernias, fatal hydrocephalus.
Dermoid and epidermoid cysts manifest themselves in embryogenesis. The contents of such cysts become fat, hair, etc.
They tend to accelerate growth, which indicates the need for urgent removal after the birth of the baby.
Pineal cysts are neoplasms of the body of the gland, they are always very small and harmless.
Signs of a cyst
If the size of the cyst in the pineal region is not more than 1 cm, it does not manifest itself and is not detected. Their diagnosis is most often random in research on other issues related to brain pathology and the passage of MRI.
The greatest danger is the growing cysts of the pineal region, which can cause circulatory disorders in the surrounding tissues and lead to hydrocephalus.
With a growing cyst, its manifestations can be as follows:
- causeless cephalgia, which are not removed by analgesics;
- diplopia;
- dizziness;
- decreased vision;
- fatigue and fatigue;
- apathy;
- insomnia at night and sleepiness during the day;
- impaired coordination and orientation.
Parasitic cysts can manifest themselves with more severe symptoms and general intoxication:
- muscle weakness;
- cramps
- developmental delay in children with speech delay;
- drop in perception of information;
- loss of vision and hearing;
- decreased tissue sensitivity;
- extrapyramidal disorders.
They are expressed in impaired motor activity due to impaired muscle tone. Either complete immobility or muscle twitching may occur.
The extrapyramidal system is responsible for the posture of a person, the accuracy of his movements and the friendly action of muscles. With extrapyramidal syndrome, all this is violated.
Diagnosis of the cyst of the pineal gland
The cause of the appearance of the cyst is usually impossible to determine. With a large tumor, a biopsy is required on atypical cells and parasites. The only way to diagnose is CT or MRI. Only they will help to suggest the cause of the development of cysts.
Epiphysis cyst treatment
In most cases, treatment of cysts of the pineal region of the brain does not require the use of drugs. The use of drugs is possible only with echinococcosis, at its earliest stage. Symptomatic treatment to eliminate the manifestations of the disease is prescribed only when they appear. And this happens when the vessels of the brain or its tissues are compressed by a growing cyst. Or they use surgical treatment - most often. Due to the complexity of access, operations are difficult and there is a large percentage of complications - 60-70%.
Indications for surgery:
- severe symptoms;
- parasitic nature of the cyst;
- cyst growth;
- hydrocephalus;
- impact on CCC.
If pathology is detected, further treatment of the cyst of the pineal region of the brain is aimed at reducing the risk of its growth.
Radical Therapies
Bypass surgery - establish drainage, with which the cyst is emptied, after which its walls fall and overgrow. But surgery can often have negative consequences for the body due to the complexity of the structure of the brain.
Endoscopy - a cyst is removed through a puncture in the skull. This method does not give complications, but there are contraindications in the form of visual impairment.
Craniotomy is an effective operation when they remove a specific area of the skull and gain access to the brain. There is a high risk of brain damage.
Complications
The most serious complication is hydrocephalus. It causes hypertension syndrome, which compresses brain tissue.
Prevention of the occurrence of the pineal cyst
Preventive measures against the formation of cysts in the pineal region of the pineal gland of the brain have not been developed. But you can reduce the risk of its occurrence:
- healthy lifestyle;
- full sleep;
- lack of exposure to the head;
- avoid head injuries;
- personal hygiene to prevent helminth infections and deworming of pets.
Symptoms of cysts in children
They are common with adults, but the development of the cyst of the pineal region in a child at an early age has its own characteristics. The child may complain of a headache, he may experience vomiting and nausea, impaired motility, and incorrect coordination is noted; complaints of blurred vision and blurriness.
With pathology of the pineal gland, STH will increase, which will lead to accelerated growth rates. Such children are superior to peers in weight and height, puberty can also be ahead or, on the contrary, delayed. Perversions of sexual desire in a child may form. What is really worth fearing when a cyst of the pineal region of the brain is detected in a child is hydrocephalus of the brain, when CSF accumulates in its ventricles.
Hydrocephalus leads to mental retardation.
Since the fontanelles of the skull in young children are not yet overgrown and the bones of the skull are soft, hydrocephalus is manifested not by squeezing the tissues, but by the expansion of the subarachnoid space due to the divergence of the bones of the skull and an increase in brain volume.
The head takes on a characteristic shape with expansion in the frontal region, which in medicine is called a symptom of an alien.
This is popularly called dropsy of the brain.
Treatment
The symptoms and treatment of the pineal cyst of the brain dictate. Any surgical intervention is always risky, so surgery in children is performed only when the benefit outweighs the risk.
Cyst monitoring means an MRI scan once every six months. With echinococcosis, anthelmintic drugs are used.
With hydrocephalus, a puncture of the subarachnoid space is performed with suction of the liquid.
With a relapse of hydrocephalus, cerebro-abdominal bypass surgery is already being performed. Its essence is that their cranial cannula is inserted into the abdominal cavity and the fluid constantly drains there, without lingering in the brain. And since fluid is constantly circulating in the stomach, cerebrospinal fluid is rapidly absorbed there.
Pituitary tumors
They are about 130 species. The most common are germinomas - 46%; astrocytomas - 27%; pineocytomas and teratomas - 6% each. The rest is even less common. A brain tumor is called glioma and can be single or multiple. 25% of tumors are benign.
Tumors of the pineal region are more common in children (they make up 3-8% of brain tumors in children) than in adults (≤1%). Sexually, they often occur in men under 20 years of age.
The clinic of pineal gland tumors almost always fits into hydrocephalus with its characteristic clinical manifestations: vomiting, increased intracranial pressure, daytime sleepiness, impaired memory, vision, an increase in the size of the cranium, convulsive syndrome, and gait disorders.
Parino's syndrome - with it, the eye cannot move vertically and vision is impaired.
Astrocytoma - refers to neuroectodermal, a malignant tumor of glial cells similar to asterisks. These cells regulate the amount of intercellular fluid. It can occur at any age.
Teratoma - is rare, most often in boys 10-12 years old. In 50% of cases, metastasizes. As it grows, it causes headaches, nausea and dizziness.
Benign pineocytoma or adenoma - develops from mature epithelial cells. It occurs at any age, but more often from 25 to 40 years. With its growth, it can also compress adjacent brain tissue. Manifestations: similar to hydrocephalus, Parino symptom, impaired coordination, trembling hands, handwriting changes, weakness and constant drowsiness, convulsive attacks.
All tumors are diagnosed with MRI and CT. Treatment - only in the form of radio and chemotherapy.