RT Journal Article SR Electronic T1 Management of pineal and colloid cysts JF Practical Neurology JO Pract Neurol FD BMJ Publishing Group Ltd SP 292 OP 299 DO 10.1136/practneurol-2020-002838 VO 21 IS 4 A1 Michael D Jenkinson A1 Samantha Mills A1 Conor L Mallucci A1 Thomas Santarius YR 2021 UL http://pn.bmj.com/content/21/4/292.abstract AB The widespread use of MRI has led to the increasingly frequent diagnosis of pineal and colloid cysts. While most are small and incidental, do not require long-term monitoring and will never need treatment, they are a cause of patient anxiety and clinician uncertainty regarding the optimal management—particularly for larger cysts or those with an atypical appearance. Occasionally pineal cysts, and more commonly colloid cysts, cause hydrocephalus that requires urgent neurosurgical treatment. More recently the non-hydrocephalic symptomatic pineal cyst has been described in the neurosurgical literature but there is controversy over this entity and its management. This review addresses the difficulties in managing pineal and colloid cysts and provides a pragmatic framework for the practising clinician.