Conservative Management of Pediatric Pineal Cyst Apoplexy: a Case Report and Literature Review

Overview

Journal Childs Nerv Syst

Specialty Pediatrics

Date 2025 Jan 3

PMID 39751845

Authors

Firat Demir

Suat Demir

Fikret Baskan

Affiliations

Soon will be listed here.

Abstract

A 5-month-old male patient presented with obstructive hydrocephalus caused by pineal cyst apoplexy. Ventriculoperitoneal shunt surgery was performed for hydrocephalus treatment. During follow-up, spontaneous shrinkage of the cyst was observed. At 24 months of follow-up, no complications were reported. Pediatric cases of pineal cyst apoplexy are rare, and little is known about its conservative management. This case report emphasizes the effectiveness of conservative treatment and close monitoring, aiming to contribute to the understanding of pineal cyst apoplexy management in the pediatric population.

References

Apuzzo M, DAVEY L, MANUELIDIS E . Pineal apoplexy associated with anticoagulant therapy. Case report. J Neurosurg. 1976; 45(2):223-6. DOI: 10.3171/jns.1976.45.2.0223. View

Arevalo A, Pulido-Rivas P, Gilo-Arrojo F, Sola R . [Haemorrhagic pineal cysts: two clinical cases successfully treated by means of microsurgery]. Rev Neurol. 2016; 63(5):206-10. View

Atallah O, Kumar C, Das S, Maurya V, Agrawal A . Sudden death in patients with pineal cyst: Evidence from autopsy studies. J Neurosci Rural Pract. 2023; 14(4):593-598. PMC: 10696342. DOI: 10.25259/JNRP_421_2023. View

Cooper E . The Human Pineal Gland and Pineal Cysts. J Anat. 1932; 67(Pt 1):28-46. PMC: 1248957. View

Durnford A, Kirkham F, Mathad N, Sparrow O . Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus: validation of a success score that predicts long-term outcome. J Neurosurg Pediatr. 2011; 8(5):489-93. DOI: 10.3171/2011.8.PEDS1166. View

Fain J, Tomlinson F, Scheithauer B, Parisi J, Fletcher G, Kelly P . Symptomatic glial cysts of the pineal gland. J Neurosurg. 1994; 80(3):454-60. DOI: 10.3171/jns.1994.80.3.0454. View

Goehner D, Soyland D, Vuong S, Trumble E . Pineal Cyst Apoplexy in an 8-Year-Old Girl: Case Report and Literature Review. World Neurosurg. 2020; 142:159-166. DOI: 10.1016/j.wneu.2020.06.199. View

Gomez-Arguelles J, Mata P, Bermejo P, Anciones B . [Worsening of migraine symptoms due to giant pineal cyst apoplexy]. Rev Neurol. 2009; 48(1):17-9. View

Kiely M . Neuroradiology case of the day. Pineal cyst with cerebral aqueduct obstruction. AJR Am J Roentgenol. 1993; 160(6):1338-9. DOI: 10.2214/ajr.160.6.8498257. View

10.

Klein P, Rubinstein L . Benign symptomatic glial cysts of the pineal gland: a report of seven cases and review of the literature. J Neurol Neurosurg Psychiatry. 1989; 52(8):991-5. PMC: 1031840. DOI: 10.1136/jnnp.52.8.991. View

11.

Koenigsberg R, Faro S, Marino R, Turz A, Goldman W . Imaging of pineal apoplexy. Clin Imaging. 1996; 20(2):91-4. DOI: 10.1016/0899-7071(94)00079-4. View

12.

Majovsky M, Netuka D, Lipina R, Mracek J, Benes V . Pineal Apoplexy: A Case Series and Review of the Literature. J Neurol Surg A Cent Eur Neurosurg. 2021; 83(1):31-38. DOI: 10.1055/s-0041-1723813. View

13.

Majeed K, Enam S . Recurrent pineal apoplexy in a child. Neurology. 2007; 69(1):112-4. DOI: 10.1212/01.wnl.0000265058.35804.f6. View

14.

Masina R, Ansaripour A, Benes V, Berhouma M, Choque-Velasquez J, Eide P . Surgical treatment of symptomatic pineal cysts without hydrocephalus-meta-analysis of the published literature. Acta Neurochir (Wien). 2021; 164(1):61-77. PMC: 8761144. DOI: 10.1007/s00701-021-05054-0. View

15.

Mattogno P, Frassanito P, Massimi L, Tamburrini G, Novello M, Lauriola L . Spontaneous Regression of Pineal Lesions: Ghost Tumor or Pineal Apoplexy?. World Neurosurg. 2016; 88:64-69. DOI: 10.1016/j.wneu.2015.12.080. View

16.

McNeely P, Howes W, Mehta V . Pineal apoplexy: is it a facilitator for the development of pineal cysts?. Can J Neurol Sci. 2003; 30(1):67-71. DOI: 10.1017/s031716710000247x. View

17.

Michielsen G, Benoit Y, Baert E, Meire F, Caemaert J . Symptomatic pineal cysts: clinical manifestations and management. Acta Neurochir (Wien). 2002; 144(3):233-42; discussion 242. DOI: 10.1007/s007010200031. View

18.

Musolino A, CAMBRIA S, Rizzo G, Cambria M . Symptomatic cysts of the pineal gland: stereotactic diagnosis and treatment of two cases and review of the literature. Neurosurgery. 1993; 32(2):315-20; discussion 320-1. DOI: 10.1227/00006123-199302000-00025. View

19.

Nimmagadda A, Sandberg D, Ragheb J . Spontaneous involution of a large pineal region hemorrhagic cyst in an infant. Case report. J Neurosurg. 2006; 104(4 Suppl):275-8. DOI: 10.3171/ped.2006.104.4.275. View

20.

Sarikaya-Seiwert S, Turowski B, Hanggi D, Janssen G, Steiger H, Stummer W . Symptomatic intracystic hemorrhage in pineal cysts. Report of 3 cases. J Neurosurg Pediatr. 2009; 4(2):130-6. DOI: 10.3171/2009.4.PEDS08309. View