Pineal Apoplexy Presenting With Recurrent Migraine-Like Headache and Transitory Neurological Dysfunction During Pregnancy

Cabral, Gonçalo; Saraiva, Marlene; Freire, Inês; Gil, Inés

doi:10.3988/jcn.2022.18.5.594

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…Intratumoral hemorrhage could lead to reoperation and usually results in disaster. Intratumoral hemorrhage of pineal region lesions was uncommon and was characterized by gaze paresis, ataxia, and intracranial hypertension (23,24). Unfortunately, the mortality rate of intratumoral hemorrhage of pineal region lesions was high (25).…”

Section: The Prevention Of Intratumoral Hemorrhagementioning

confidence: 99%

Optimal therapeutic strategies for pineal region lesions

Huang,

Wang,

et al. 2023

Front. Neurol.

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BackgroundThe removal of pineal region lesions are challenging, and therapeutic strategies for their removal remain controversial. The current study was conducted to identify the characteristics and the optimal therapeutic strategies for pineal region lesions.MethodsThis retrospective study reviewed the treatments of 101 patients with pineal region lesions, and different characteristics and therapeutic strategies were observed.ResultsThere were no statistical differences in the total resection ratio, complications, and prognosis outcomes between the hydrocephalus group and non-hydrocephalus group, except patients in the hydrocephalus group were younger and pediatric patients had an increased level of intracranial infections. Treatments of lesions and hydrocephalus secondary to pineal region lesions were two integral parts to therapeutic strategies. For the management of lesions, germinoma or non-germinoma were diagnosed preoperatively, and resection or diagnostic radiation were chosen to deal with pineal region lesions. Endoscopic-assisted surgery provided a higher total resection rate. For the management of hydrocephalus, endoscopic third ventriculostomy (ETV) had the better therapeutic effect. Additionally, cerebrospinal fluid (CSF) diversion before radiotherapy or resection did not improve prognosis outcome, but it was necessary for patients with severe hydrocephalus. Logistical regression analysis indicated that age, lesion size, reoperation ratio, and intracranial complications were predictors of prognosis outcome.ConclusionMore attention should be paid to intracranial infections in pediatric patients with hydrocephalus secondary to pineal region lesions, and CSF diversion before radiotherapy or resection did not promote prognosis outcome, but it was necessary for patients with severe hydrocephalus. Age, lesion size, reoperation ratio, and intracranial complications may be the predictors of prognosis outcome. Most importantly, the surgical algorithm for pineal region lesions which was based on preoperatively diagnosis (non-germinoma and germinoma) is useful, especially for developing countries.

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Section: The Prevention Of Intratumoral Hemorrhagementioning

confidence: 99%

Optimal therapeutic strategies for pineal region lesions

Huang,

Wang,

et al. 2023

Front. Neurol.

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Pineal cyst apoplexy in a pregnant female. Case Report

Azab,

Hazim,

El-Gohary

et al. 2024

Preprint

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Background: Pineal cyst is an uncommon condition in pregnancy. It is often encountered as an incidental finding in brain imaging. Most of pineal cysts are benign and asymptomatic. Bleeding inside these cysts is very rare in pregnancy. Clinical presentation: A 30-year-old female patient with no significant past medical history, presented to the emergency department at 36 weeks gestation with an episode of transient unilateral headache. Headache was associated with dizziness and left arm ascending numbness. Neurological examination was normal. Investigations: She has a history of a known pineal cyst. CT head was obtained, reviewed and compared to previous scans 7 years ago. It showed that the pineal cyst had a suspected bleeding. Management: The patient was admitted to the neurosurgery department for conservative management without any surgery and few days later, symptoms gradually improved. Follow-up: Three weeks later, the patient reported spontaneous improvement of the presenting symptoms. The decision was to proceed with continued watchful follow-up and awaiting a caesarian section delivery. Patient returned for follow up three months later without any symptoms. Following delivery, the patient remained asymptomatic and no further problems occurred during the postpartum period. Conclusion: Pineal cyst apoplexy is a relatively rare condition and it usually affects young adult females, however, the exact relation to pregnancy and the effect of apoplexy on the course of pregnancy is not well defined.

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Pineal Apoplexy Presenting With Recurrent Migraine-Like Headache and Transitory Neurological Dysfunction During Pregnancy

Cited by 2 publications

References 10 publications

Optimal therapeutic strategies for pineal region lesions

Optimal therapeutic strategies for pineal region lesions

Pineal cyst apoplexy in a pregnant female. Case Report

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