Pineal apoplexy associated with anticoagulant therapy. Case report

Area of Science:

• Neurosurgery
• Neurology
• Pathology

Background:

• Pineal cysts are common, typically asymptomatic lesions.
• Hemorrhage into a pineal cyst is a rare event.
• Anticoagulant therapy can increase the risk of bleeding in cystic lesions.

Observation:

• A patient on anticoagulant therapy developed sudden onset of pineal region syndrome.
• Clinical presentation included symptoms and signs indicative of increased intracranial pressure and neurological deficits.
• Imaging confirmed hemorrhage within a pineal cyst.

Findings:

• The hemorrhage into the pineal cyst was the direct cause of the acute neurological syndrome.
• Surgical excision of the hemorrhagic pineal cyst led to complete resolution of symptoms and signs.
• Histopathological examination confirmed the nature of the lesion and the hemorrhage.

Implications:

• This case highlights a rare but serious complication of pineal cysts in patients on anticoagulation.
• Prompt surgical intervention is crucial for managing acute symptomatic hemorrhage in pineal cysts.
• Understanding the risk factors and management strategies is vital for neurosurgeons and neurologists.