I am a 41yo female with a symptomatic pineal cyst that is causing double vision. I have gone to two neuro-ophthalmologists who both disgnosed me with dorsal midbrain syndrome. I have always had this cyst and the size has not changed that much over the years except for increased calcification. In addition I have seen two neurologists, and two neurosurgeons who agree that this cyst needs to be removed/fenestrated. There is also a VI or pseudo VI nerve palsy in addition to the partial IV. I am scheduled for supracerebellar/infratentorial sitting craniotomy. The cyst is the only thing showing up on my MRI. Could something else be causing my double vision? I have not had any trauma but my vision also just goes blurry. What other things might cause this vision problem? Are there any other tests that I should have done? Could this be vascular in origin? or would that show up on the MRI?
In general, a pineal tumor can cranial nerve deficits. However, they are the only cause of cranial nerve deficits. I do not have your records or films to review, however getting multiple opinions is a good thing to do to understand your condition. If you are still concerned after getting a 2nd opinion, it is reasonable to get another opinion. Sometimes, getting another consultation will help you better understand your condition and allow you feel more involved in your decision.
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