Pineal apoplexy associated with anticoagulant therapy

Apuzzo, Michael L.J.; Davey, Lycurgus M.; Manuelidis, Elias E.

doi:10.3171/jns.1976.45.2.0223

Cited by 53 publications

(25 citation statements)

References 23 publications

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“…Old and recent areas of hemorrhage were identified microscopically in the resected pineal cyst of a patient with pineal apoplexy (23). The release of the debris accumulated by a single or recurrent intracystic hemorrhage seems to be able to cause meningitis with polymorphonuclear CSF pleocytosis.…”

Section: Discussionmentioning

confidence: 99%

A Hemorrhagic Pineal Cyst with a Bacterial Meningitis-like Manifestation and Benign Outcome

et al. 2013

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Pineal cysts are a common incidental finding in imaging studies, and the majority of such cysts are asymptomatic. However, hemorrhaging pineal cysts, which are considered to be rare, are often associated with severe symptoms. We herein describe the case of a 58-year-old patient with the novel manifestation of a bleeding pineal cyst, who had a benign outcome without any surgical treatment. Although the clinical manifestations resembled those of bacterial meningitis, magnetic resonance images suggested chemical meningitis caused by an intracystic hemorrhage and rupture of the pineal cyst.

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Section: Discussionmentioning

confidence: 99%

A Hemorrhagic Pineal Cyst with a Bacterial Meningitis-like Manifestation and Benign Outcome

et al. 2013

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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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“…Porém, já foi descrita hemorragia intracisto provocando efeito expansivo e compressão da lâmina quadrigeminal 17 .…”

Section: Fig 3 Cisto Pineal (õ) Em Corte Coronal T1 Antes (A) E Apósunclassified

Estudo por ressonância magnética da região da pineal: pineal normal e cistos simples

Caldas

Doyon

Lederman

et al. 1998

Arq. Neuro-Psiquiatr.

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RESUMO -Realiza-se um estudo por ressonância magnética da pineal normal e dos cistos simples da pineal e estabelece-se um protocolo para estudo da região pineal analisando-se 762 exames. A utilização da técnica com cortes finos (3 milímetros no máximo) identifica a pineal normal na maioria das vezes (84,4%) e demonstra que a pineal normal, sem cistos, apresenta sinal isointenso em Tl e T2 com realce após a injeção de gadolínio, medindo em média 6,1 milímetros no seu maior diâmetro. Os cistos simples da pineal aparecem com frequência de 2,6% em relação a toda a série (762 casos) elevando-se essa frequência para 6,1% se forem consideradas somente as pineais visiblizadas (329 casos). Os cistos simples não se correlacionam nem com a idade nem com o sexo e os cistos sintomáticos são raros. Os critérios para diagnóstico diferencial dos cistos simples versus tumores da região da pineal são: dimensões menores ou iguais a 20 milímetros; espessura da parede abaixo de 2 milímetros; ausência de efeito expansivo; sinal igual ao líquido cefalorraquidiano e ausência de crescimento dos cistos.PALAVRAS-CHAVE: cistos da pineal, glândula pineal, tumores encefálicos, radiodiagnóstico, ressonância magnética.Magnetic resonance study of the pineal region: normal pineal gland, simple cysts ABSTRACT -A magnetic resonance imaging (MRI) study of the normal pineal gland and pineal simple cysts was performed in 762 cases. A fine section technique (maximum 3 millimeters) enabled most of the times the identifying of a normal pineal in addition to demonstrating that a pineal without any cyst shows an isointense signal in Tl and T2 which, in turn, is enhanced following gadolinium. The measure of the normal pineal was of about 6.1 millimeters in its diameter length. Pineal simple cysts were observed in a 2.6% frequency in relation to the whole series (762 cases); however reaches 6.1% when only the visualized pineals were considered (329 cases). Also, it was found out that simple cysts were not correlated to age or gender. Simple cysts characteristics are: dimension less or equal to 20 millimeters; absence of expansive effect; similar signal to that of the cerebrospinal fluid; absence of cyst growth.KEY WORDS: pineal cysts, pineal gland, encephalic tumors, magnetic resonance imaging.A glândula pineal tem a forma de pinha, de onde o seu nome, mede 5-9 mm no seu maior diâmetro e tem peso variando de l50 a 220 mg l,2 . Situa-se acima da extremidade póstero-superior do terceiro ventrículo, abaixo do esplênio do corpo caloso e repousa na depressão que existe entre os

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Pineal apoplexy associated with anticoagulant therapy

Abstract: A case is presented with the acute development of a pineal region syndrome secondary to hemorrhage into a pineal cyst in a patient who was under anticoagulant therapy. Resolution of the symptoms and signs followed excision of the lesion.

Cited by 53 publications

References 23 publications

A Hemorrhagic Pineal Cyst with a Bacterial Meningitis-like Manifestation and Benign Outcome

A Hemorrhagic Pineal Cyst with a Bacterial Meningitis-like Manifestation and Benign Outcome

Prevalence and natural history of pineal cysts in adults

Estudo por ressonância magnética da região da pineal: pineal normal e cistos simples

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