Sudden death due to a glial cyst of the pineal gland.

Milroy, Christopher M.; Smith, Colin

doi:10.1136/jcp.49.3.267

Cited by 41 publications

(25 citation statements)

References 8 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. In 2009, Sarikaya-Seiwert et al 58 surveyed the literature and found 28 reported cases.…”

Section: Discussionmentioning

confidence: 87%

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: 87%

Prevalence and natural history of pineal cysts in adults

Al-Holou¹,

Terman²,

Kilburg³

et al. 2011

JNS

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“…Sudden death in the setting of acute hydrocephalus with rapid increase of the intracranial pressure, is a well recognised situation in which an underlying pathology or cause can be established in a number of cases consisting, for example, of acute blockage of the interventricular foramina or the aqueduct by colloid cysts of the third ventricle (Buttner et al 1997;Shemie et al 1997;Aronica et al 1998), neoplasms (Shemie et al 1997), lipomas (Zappi et al 1993), pineal cysts (Milroy and Smith 1996;Mena et al 1997) or other causes such as sarcoidosis (Maisel and Lynam 1996), neurocysticercosis (Verma et al 1998), DandyWalker malformation (Elterman et al 1995) and arachnoid cysts (Norman et al 1995). These events are usually accompanied or preceded by neurological symptoms, most notably headaches, nausea or blurred vision.…”

Section: Introductionmentioning

confidence: 99%

Sudden unexpected death in young adults with chronic hydrocephalus

Rickert¹,

Grabellus

Varchmin-Schultheiß

et al. 2001

International Journal of Legal Medicine

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We present four cases of sudden unexpected death in young adults with chronic hydrocephalus. The patients were between 20 and 28 years of age and had suffered from aqueduct stenosis (two patients), spina bifida in combination with Arnold-Chiari malformation (type II) and fragile X-syndrome. The patients suddenly collapsed with cardiorespiratory failure and could not be resuscitated and none had a history of headache or seizures. The post-mortem examinations revealed no unusual findings and a definite cause of death could not be established. Neuropathological examination revealed chronically hydrocephalic brains without any signs of uncal or tonsillar herniation. We hypothesise that a sudden pressure-induced decompensation of cerebral neuronal pathways involving insular and limbic cortex, hypothalamus and brain stem nuclei, may have caused disturbances of the cardiopulmonary control centres in the reticular formation of the brain stem, which in turn may have led to instantaneous cardiorespiratory arrest resulting in sudden "neurogenic" cardiac death.

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“…2,11 Cases of pineal apoplexy that cause sudden death from an intracystic hemorrhage also have been reported. [12][13] Several retrospective studies of consecutive MR imaging scans showed that the prevalence of cysts ranges from 1.5% to 10.8%. [5][6]8,[14][15][16] Most studies were conducted in patients with neurologic symptoms suggestive of an intracranial pathologic condition.…”

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confidence: 99%