Pineal Region Lesions. Management Strategies and Controversial Issues

I Overview.- 1 Historical landmarks in pineal region surgery.- 2 Pineal region anatomy.- 3 Pathology of Pineal Region Lesions .- 4 Clinical presentation.- 5 Imagistic diagnosis.- 6 The Usefulness of Biomarkers for Diagnosis .- 7 Surgical Adjuvants for pineal region approach.- II Surgical approaches for pineal region lesions.- 8 Supracerebellar infratentorial approach .- 9 Occipital transtentorial approach.- 10 Transcallosal approach.- 11 Endoscopic approaches for pineal region lesions.- 12 Management of Hydrocephalus.- III Adjuvant therapies.- 13 Radiosurgery.- 14 Other radiotherapeutic techniques.- 15 Chemotherapy.- IV Pineal region tumors.- 16 Tumors of Pineal Cell Origin.- 17 Tumors of germ cell origin.- 18 Tumors of glial origin.- 19 Meningiomas of the pineal region.- 20 Metastatic tumors.- V Vascular lesions of the pineal region.- 21 Arterio-venous malformations.- 22 Cavernomas.-23 Vein of Galen Aneurismal Malformation.- VI Cysts and Cyst -Like Lesions of the pineal region.- 24 Epidermoids and Dermoids.- 25 Pineal Cyst.- VII Miscellanea.- 26 Management algorithms.- 27 Conclusions.

Neurosurgical lesions of the pineal region are extremely rare, accounting for roughly 1% of the total number of neurosurgical expansive lesions in modern practice. This book offers an up-to-date review of the relevant literature, combined with the personal perspectives of some highly experienced figures in the field. The book is divided into two main parts, the first of which offers an overview of the pineal region from an anatomic, pathologic, imaging and therapeutic perspective. Special attention is given to surgical approaches to pineal region lesions. Microsurgical techniques are presented, together with detailed indications regarding specific locations of these lesions, specific complications, and controversial aspects concerning some of the approaches. A dedicated chapter addresses endoscopic techniques, their indications and limitations. Adjuvant therapies are also discussed, along with their particular indications and debated aspects.

In turn, the chapters in the second part cover specific lesions such as pineal region tumors, vascular lesions, and cystic and cyst-like lesions. Regarding pineal region tumors, the most frequent pathologies are presented in the most comprehensive and practical manner possible, with special attention to the appropriate therapeutic management for each type. Further, there is a dedicated chapter on pineal region cysts. Given its depth of content, the book will allow neurosurgeons and specialists to greatly expand their understanding of pineal region lesions in daily clinical practice.

Professor Florian graduated from the Faculty of Medicine, Institute of Medicine and Pharmacy Cluj-Napoca and subsequently became a specialist neurosurgeon. He was appointed an Assistant Professor of the Neurosurgery Department of the University of Medicine and Pharmacy (UMF) "Iuliu Hatieganu" Cluj-Napoca, where he has been a Professor since 2007. He has served as Head of the Neurosurgical Department, Clinical Emergency Cluj County Hospital since 2001, and was Vice-Dean of the Faculty of Medicine from 2007 to 2012. As a senior neurosurgeon, he has performed more than 16,000 neurosurgical interventions, with no fewer than 800 surgeries per year in the last 5 years.

His personal areas of interest are neuro-oncology, cerebrovascular pathology, pediatric neurosurgery and neurotrauma. Further, he is intensively involved in continuous medical education for young neurosurgeons (over the past 10 years he has organised several national and international congresses, as well as various international courses and Master Classes).

He has authored 11 books, 28 book chapters, and 54 ISI-indexed publications, and is a member of various national and international professional societies. He was President of the Romanian Society of Neurosurgery from 2010 to 2012 and 2016 to 2018, and has been President of the EMN (Euroacademia Multidisciplinaria Neurotraumatologica) since 2015; a corresponding member of the Romanian Academy of Medical Science since 2016; Second Vice President at large of the WFNS since 2017; and Vice-President of the Southeast European Society of Neurosurgery (SeENS) since 2017.