Pineal cyst

Case contributed by Mostafa Elfeky
Diagnosis certain

Presentation

Headache, mild distal weakness and acute hyperreflexia.

Patient Data

Age: 5 years
Gender: Female
mri
This study is a stack
Axial
T1
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Sagittal
T1
This study is a stack
Axial
T2
This study is a stack
Coronal
T2
This study is a stack
Sagittal
CISS
This study is a stack
Axial
FLAIR
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial
T1 C+
This study is a stack
Sagittal
T1 C+
This study is a stack
Coronal
T1 C+
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Info

Pineal gland cyst is noted measuring 1.5 x 1 x 1.1 cm in dimensions.  It is displaying CSF-like clear fluid intensities along all MRI sequences, no diffusion restriction and a thin rim of enhancement.  It is indenting the upper part of the tectal plate of midbrain compressing the superior colliculi. It is slightly indenting the posteromedial aspect of both thalami. It is smoothly stretching the fine vascular structures of the pineal region.

Case Discussion

MRI study shows a well-defined pineal cyst, no other findings are noted that could be a possible cause for the presenting neurological manifestations. A pineal cyst is always asymptomatic and incidental finding, especially if less than 1 cm. if large or have atypical features, they cannot be distinguished from cystic tumors.

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