% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{SchmutzerSondergeld:298408,
      author       = {M. Schmutzer-Sondergeld and A. Gencer and T. Schmidlechner
                      and H. Zimmermann and S. Niedermeyer and S. Katzendobler and
                      V. M. Stoecklein and T. Liebig and C. Schichor and N.
                      Thon$^*$},
      title        = {{C}omparison of surgical approaches and outcome for
                      symptomatic pineal cysts: microscopic/endoscopic
                      fenestration vs. stereotactic catheter implantation.},
      journal      = {Acta neurochirurgica},
      volume       = {167},
      number       = {1},
      issn         = {0001-6268},
      address      = {Wien [u.a.]},
      publisher    = {Springer},
      reportid     = {DKFZ-2025-00264},
      pages        = {27},
      year         = {2025},
      abstract     = {Treatment strategies for space-occupying/symptomatic pineal
                      cysts (PC) are still up for debate. In this study we present
                      PC management, outcome data and risk factors for recurrence
                      after surgery, focusing on microscopic/endoscopic procedures
                      vs. stereotactic catheter implantation as alternative
                      treatment concept to permanently drain PC into
                      ventricles/cisterns.This monocentric retrospective analysis
                      included clinical data from all consecutive PC patients
                      treated surgically between 2000 and 2022. Postoperative
                      neurological and functional outcomes, along with
                      perioperative complications, as well as time to PC
                      recurrence and MR-morphological data were evaluated.39
                      patients (median age 32.6 years, range: 5.1-71.6 years) were
                      analyzed. Main presenting symptoms were headaches, visual
                      impairment, and epileptic seizures. In 18 patients
                      $(46.2\%)$ an enlarged ventricular system was preoperatively
                      found with 7 patients $(18.0\%)$ suffering from occlusive
                      hydrocephalus. 14 patients underwent microscopic/endosocopic
                      surgery, in 25 cases stereotaxy was preferred. No
                      complication was seen in the microsurgery/endoscopy group
                      compared to one intracystic postoperative bleeding $(2.6\%)$
                      and two CSF leaks $(5.1\%)$ after stereotaxy (p = 0.5).
                      Overall, clinical improvement and significant cyst volume
                      reduction (p < 0.0001) was seen in all patients. Recurrent
                      PC were seen in $23.1\%,$ independent of surgical procedure
                      (p = 0.2). In cases of recurrence, TTR was 25.2 ± 31.2
                      months. Male gender (p = 0.01), longer surgery time (p =
                      0.03) and preoperatively increased Evans index (EI) (p =
                      0.007) were significant risk factors for PC recurrence in
                      multivariate analysis.In patients suffering from PC,
                      microsurgical and stereotactic approaches can improve
                      clinical symptoms at low procedural risk, with equal extent
                      of volume reduction. However, preoperative ventricular
                      enlargement and EI values should be considered for optimal
                      treatment planning to reduce recurrence.},
      keywords     = {Humans / Middle Aged / Male / Female / Adult / Aged /
                      Retrospective Studies / Adolescent / Young Adult / Treatment
                      Outcome / Child / Stereotaxic Techniques / Child, Preschool
                      / Central Nervous System Cysts: surgery / Microsurgery:
                      methods / Neuroendoscopy: methods / Pineal Gland: surgery /
                      Pineal Gland: pathology / Cysts: surgery / Postoperative
                      Complications: etiology / Pinealoma: surgery / Endoscopy
                      (Other) / Evans index (Other) / FOHR (Other) / Microsurgery
                      (Other) / Pineal cysts (Other) / Stereotaxy (Other)},
      cin          = {MU01},
      ddc          = {610},
      cid          = {I:(DE-He78)MU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39888450},
      pmc          = {pmc:PMC11785698},
      doi          = {10.1007/s00701-025-06445-3},
      url          = {https://inrepo02.dkfz.de/record/298408},
}