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Pineal cavernous malformations: report of two cases.

Dong-Seok Kim1, Kyu-Won Shim, Tae-Gon Kim

  • 1Department of Neurosurgery, Yonsei University College of Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.

Yonsei Medical Journal
|December 31, 2005
PubMed
Summary

Pineal hemorrhage is rare, often caused by cavernous malformations. Early surgical intervention is recommended for pineal cavernous malformations based on typical radiological findings.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Pineal hemorrhage is a rare condition with diverse causes, including vascular malformations like cavernous malformations.
  • Pineal cavernous malformations are exceptionally rare, with only fifteen cases reported globally.

Observation:

  • Two cases of pineal cavernous malformation presenting with acute hemorrhage are described.
  • Patients experienced neurological deficits, including limited upward gaze and diplopia, which worsened after ventriculo-peritoneal (VP) shunting.

Findings:

  • Diagnosis of pineal cavernous malformation can be challenging due to its rarity but is suggested by characteristic radiological findings.
  • Surgical removal via an occipital-transtentorial approach was successful in both cases, resolving the hemorrhages and associated symptoms.

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Implications:

  • Early surgical intervention is strongly recommended for diagnosed pineal cavernous malformations, avoiding potentially risky biopsies.
  • This study emphasizes the importance of recognizing radiological signs for timely diagnosis and effective management of these rare lesions.