Atypical Presentation of an Apoplexy in a Pineal Cyst

Objectives: Apoplexy in a pineal cyst is a rare condition, with always headache or signs of increased intracranial pressure due to secondary hydrocephalus. Methods: We describe a patient with recent intra-cystal haemorrhage with vertigo, but without any headache symptoms. We also conducted a literature review. Results: This study focusses on a case report of a patient in whom apoplexy in the pineal cyst was detected as an incidental finding. Magnetic Resonance Imaging showed a recent haemorrhage within a 15 × 10 × 8 mm cyst of the pineal gland, without changes during follow-up. Clinically, however, the patient did not have any typical symptoms of headache or deterioration in the level of consciousness. Conclusion: Pineal apoplexy can also present as an asymptomatic incidental finding, or as the cause of transient vertigo and eye-movement disorder.