Pineal apoplexy: an occurrence with no diagnostic clinicopathological features

Swaroop, G; Whittle, Ian R.

doi:10.1080/02688699845140

Cited by 22 publications

(9 citation statements)

References 13 publications

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“…It may be associated with an increased likelihood of symptomatic presentation, 5,19,20,49,58,63 and sudden death from pineal hemorrhage with acute hydrocephalus has been reported. 41,55 Fleege et al 20 found fluid-fluid levels consistent with previous hemorrhage in 3 of 19 patients who presented with symptomatic pineal cysts.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and natural history of pineal cysts in adults

Al-Holou¹,

Terman²,

Kilburg³

et al. 2011

JNS

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Object We reviewed our experience with pineal cysts to define the natural history and clinical relevance of this common intracranial finding. Methods The study population consisted of 48,417 consecutive patients who underwent brain MR imaging at a single institution over a 12-year interval and who were over 18 years of age at the time of imaging. Patient characteristics, including demographic data and other intracranial diagnoses, were collected from cases involving patients with a pineal cyst. We then identified all patients with pineal cysts who had been clinically evaluated at our institution and who had at least 6 months of clinical and imaging follow-up. All inclusion criteria for the natural history analysis were met in 151 patients. Results Pineal cysts measuring 5 mm or larger in greatest dimension were found in 478 patients (1.0%). Of these, 162 patients were male and 316 were female. On follow-up MR imaging of 151 patients with pineal cyst at a mean interval of 3.4 years from the initial study, 124 pineal cysts remained stable, 4 increased in size, and 23 decreased in size. Cysts that were larger at the time of initial diagnosis were more likely to decrease in size over the follow-up interval (p = 0.004). Patient sex, patient age at diagnosis, and the presence of septations within the cyst were not significantly associated with cyst change on follow-up. Conclusions Follow-up imaging and neurosurgical evaluation are not mandatory for adults with asymptomatic pineal cysts.

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Section: Discussionmentioning

confidence: 99%

Prevalence and natural history of pineal cysts in adults

Al-Holou¹,

Terman²,

Kilburg³

et al. 2011

JNS

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“…3,4 On the other hand, almost all cases described so far are associated with a 'lesion'. 5,6 In this context, pineal apoplexy can be related to haemorrhage into a pineal cyst, bleeding of a tumour or rupture of a vascular malformation. Sometimes apoplexy may follow an ischemic event in the context of a tumour.…”

Section: Discussionmentioning

confidence: 99%

“…Sometimes apoplexy may follow an ischemic event in the context of a tumour. 6 Indeed, large tumours may compress or outgrow the feeding vessels, especially those coming from the lateral pineal artery, which often provides monolateral vascularisation to the pineal gland. An ischemic mechanism can be hypothesised when neuroimaging exams do not show signs of haemorrhage, as happened in the present case.…”

Section: Discussionmentioning

confidence: 99%

Vanishing pineal mass in a young patient without therapy: Case report and review of the literature

et al. 2016

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Spontaneous regression is defined as the decrease in size or disappearance of a primary tumour or metastatic disease without therapeutic intervention. Computed tomography and magnetic resonance imaging (MRI) of the brain was performed in a 14-year-old girl experiencing sudden-onset headaches. First diagnostic exams revealed a mass in the pineal region that disappeared at three-month MRI control. Three-year follow-up MRI studies were performed. No therapy was administered, but the pineal lesion had disappeared at three-year follow-up.

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“…Pineal cysts are relatively common, and they occurr in as much as 1.4 to 4.3% of the patients that undergo MR imaging. These cysts can become symptomatic, and there have been about 75 verified cases reported in the literature so far 5,15,17,23. However, their hemorrhagic manifestation is extremely rare, with only 8 such cases being found in the literature 5,15-17,23-27.…”

Section: Discussionmentioning

confidence: 99%

Pineal Cavernous Malformations: Report of Two Cases

et al. 2005

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Pineal hemorrhage only occurs in rare cases, and this known to have several different causes such as germ cell tumors, pineal cysts and vascular malformations, including the cavernous malformations. Pineal cavernous malformations are extremely rare: to date only fifteen cases have been reported worldwide. Although the diagnosis of pineal cavernous malformation is not easy because of the extreme rareness of this condition, the presence of this lesion can be suspected based on its typical radiological findings. Case 1. A 42-year- old man presented with a limitation in his upward gazing. Radiologic examinations showed acute hemorrhage in the pineal region. He underwent ventriculo-peritoneal (VP) shunting but the patient's condition deteriorated after the shunting surgery. We operated and totally removed the tumor and the hemorrhages via an occipital-transtentorial approach. Case 2. A 37-year-old man presented with diplopia. Radiologic examinations showed acute hemorrhage in the third ventricle. He underwent VP shunting, and after this procedure the diplopia was aggravated. We operated and totally removed the tumor and the hemorrhages via an occipital-transtentorial approach. If there is no doubt about the pineal cavernous malformation on MR imaging, we strongly recommend early surgical intervention without performing a risky biopsy. In this study, we describe our experiences for the diagnosis of cavernous malformations in the pineal region with special emphasis on the radiological aspects and the clinical course of this disease.

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Pineal apoplexy: an occurrence with no diagnostic clinicopathological features

Cited by 22 publications

References 13 publications

Prevalence and natural history of pineal cysts in adults

Prevalence and natural history of pineal cysts in adults

Vanishing pineal mass in a young patient without therapy: Case report and review of the literature

Pineal Cavernous Malformations: Report of Two Cases

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