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Headache, mild distal weakness and acute hyperreflexia.
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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.
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.