Strokes can affect any part of the brain. A stroke in the deeper structures of the brain (thalamus, basal ganglia or pons) is called a lacunar stroke. These deep structures have a very unique blood supply – very small arteries that lead directly off much larger arteries.
The white matter of the brain are the nerve fibres (coated in myelin sheaths) that conduct nerve impulses quickly throughout the brain and spinal cord. The white matter connects various grey matter areas of the brain to each other. The myelin acts as an insulator, and increases the speed of the nerve impulses.
The brain has a rich network of blood vessels, ranging from the large arteries to the tiny vessels deep in the brain. The term ‘Chronic Small Vessel Disease’ (CSVD) refers to the physical changes caused by small vessel disease including thickening of the vessel walls, disturbance of the blood-brain barrier, and demyelination of the nerve sheaths.
Pineal Cysts are usually small, benign (not malignant) cysts located in the Pineal Gland in the brain. Most are small (>5mm) and these small cysts are common, and often an incidental finding on MRI. Small cysts do not cause symptoms.
Larger Cysts (<10mm) are more rare, and may be symptomatic. The importance of Pineal Cysts is that they cannot be distinguished from Pineal Tumours on MRI alone. Larger cysts, or cysts with irregular features may actually be a Cystic Pineocytoma, a slow growing malignant pineal tumour. But a tumour cannot be definitively diagnosed without tissue samples, which involves invasive surgery. If it is a Cystic Pineocytoma, the prognosis is excellent, when the tumour is completely removed surgically. Treatment also sometimes requires radiation and chemotherapy in severe cases. The five year survival rate is 86%, so if you have to have a brain tumour, this is a good one to have.