Pineal Cyst Apoplexy in an 8-Year-Old Girl: Case Report and Literature Review

World Neurosurg. 2020 Oct:142:159-166. doi: 10.1016/j.wneu.2020.06.199. Epub 2020 Jun 29.

Abstract

Background: Pineal cysts are common, typically asymptomatic, and are usually found incidentally in adults. In rare cases, pineal cyst apoplexy occurs as a result of an acute cystic hemorrhage. This situation can result in acute onset of severe headaches, acute obstructive hydrocephalus, mass effect on the midbrain, and even death. Pineal apoplexy is most common in women of reproductive age, whereas pediatric cases continue to be less prevalent. Pineal cyst apoplexy remains a rare entity with ≥30 cases presented in the literature to date.

Case description: We present the youngest case in the literature (an 8-year-old girl with a pineal cyst that resulted in apoplexy), her diagnostic workup, management, and follow-up. We supplement our case study with a literature review of pineal cyst apoplexy.

Conclusions: Pineal cyst apoplexy remains a rare clinical event in the pediatric population. Our case details the diagnosis and management of an 8-year-old girl with pineal cyst apoplexy. We also discuss our findings from our literature search for all reported cases of pineal cyst apoplexy.

Keywords: Hydrocephalus; Pediatric neurosurgery; Pineal apoplexy; Pineal cyst; Pineal cyst hemorrhage.

Publication types

  • Case Reports

MeSH terms

  • Central Nervous System Cysts / complications*
  • Central Nervous System Cysts / diagnostic imaging
  • Central Nervous System Cysts / surgery*
  • Child
  • Female
  • Humans
  • Pineal Gland / diagnostic imaging
  • Pineal Gland / surgery*
  • Pituitary Apoplexy / complications*
  • Pituitary Apoplexy / diagnostic imaging
  • Pituitary Apoplexy / surgery*