Related Experiment Video
Updated: May 6, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
19.0K
Pineal Cyst Associated with Apoplexy and Hydrocephalus: A Case Report
Daniel Marchi Kieling1, Amanda Hedel Koerich1, Romildo Antonio Dos Santos Júnior1
1Neurology and Neurosurgery Service of Passo Fundo-Neurosurgery Department.
Current Health Sciences Journal
|July 18, 2025
Summary
Pineal cysts are usually benign but can cause serious complications like pineal apoplexy. This case report details the successful management of a complicated pineal cyst in a young male.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Pineal cysts (PCs) are frequently identified on magnetic resonance imaging (MRI).
- Most pineal cysts are incidental findings and remain asymptomatic throughout a patient's life.
- However, rare complications such as pineal apoplexy can occur, necessitating urgent medical evaluation.
Observation:
- A 19-year-old male presented with progressive headache and declining vision.
- MRI revealed a 2.3 cm pineal cyst with hemorrhagic features, indicative of apoplexy.
- The cyst was causing obstructive hydrocephalus, leading to increased intracranial pressure.
Findings:
- The patient underwent successful endoscopic third ventriculostomy and subsequent microsurgical resection of the pineal cyst.
- Post-operative imaging confirmed successful cyst removal and resolution of hydrocephalus.
- The patient experienced complete resolution of his presenting symptoms.
Implications:
- This case underscores that while often benign, complicated pineal cysts can present as life-threatening emergencies.
- Effective management involves prompt diagnosis, differential consideration of pineal apoplexy, and timely surgical intervention.
- Understanding the etiology, diagnosis, and treatment of complicated pineal cysts is crucial for improving patient outcomes and advancing neurosurgical knowledge.
Related Concept Videos
01:26Brain Abscess l: Introduction
48
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial...
48
01:14Increased Intracranial Pressure l: Introduction
31
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component...
31
01:29Increased Intracranial Pressure ll: Pathophysiology
43
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins...
43
01:19Cerebral Edema l: Introduction
35
Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
35
01:22Cerebral Edema ll: Pathophysiology
31
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
31
01:21Cytotoxic Edema: Pathophysiology
31
Cytotoxic edema is a form of cerebral edema characterized by intracellular swelling of neurons, astrocytes, and other glial cells. It develops when the mechanisms responsible for maintaining ionic gradients across the cell membrane become impaired. Under normal physiological conditions, the sodium–potassium ATPase actively transports sodium ions out of the cell and potassium ions into the cell, preserving osmotic balance and enabling electrical signaling. This pump requires a continuous...
31