The epithalamus is the small upper back part of the diencephalon. It includes the habenula, the stria medullaris, the habenular and posterior commissures and the pineal gland. It links the limbic forebrain with the midbrain and contributes to circadian and reward-related control.
| Location | Posterior roof of the third ventricle, above and behind the thalamus, just in front of the superior colliculi |
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| Parts |
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| Connections |
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| Blood Supply | Medial posterior choroidal arteries |
Connects emotional and reward systems of the forebrain to midbrain monoamine centres, and through the pineal gland helps signal day length to the body.
Pineal region tumours compress the posterior commissure and dorsal midbrain, producing Parinaud syndrome with upward gaze palsy, and can block the cerebral aqueduct to cause hydrocephalus. Calcification of the habenula and pineal is a common normal finding on CT in adults.
Germinomas or pineal tumours that compress the dorsal midbrain and aqueduct, causing upgaze palsy and obstructive hydrocephalus.
Dorsal midbrain syndrome with impaired upward gaze, light-near dissociation of the pupils and convergence-retraction nystagmus.
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