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Headaches for assessment.
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MRI demonstrates a cyst in the pineal region. On T2 sequences, signal largely follows CSF but does not fully attenuate on FLAIR. Internal cerebral veins (arrow) are elevated and splayed. Typical appearances of an incidental pineal cyst, almost certainly not the cause of the patient's headaches.
Pineal cysts are common and in patients being investigated for vague symptoms, such as headaches, they are troublesome as it is difficult to be completely sure, and more importantly even harder to convince the patient, that the cyst is truly incidental.
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