Pineal hemorrhage [Neurosurgery Wiki]

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====== Pineal hemorrhage ======

It is very important to perform the [[differential diagnosis]] because [[pineal hemorrhage]] is very rare and it may be associated with many different causes. The possible causes of [[pineal]] hemorrhages are [[pineal region tumor]]s
((Hung YC, Lee EJ, Wang LC, Chen HH, Yan JJ, Yu CY. Mixed germ cell tumor presenting as intratumoral hemorrhage: report of a case originated from the pineal region. Kaohsiung J Med Sci. 1999;15:498–503.))
((Maruki C, Takara K, Abe K, Tsunoda A, Ebato M, Ikeya F. Primary pineal embryonal carcinoma occurring in a middle aged man. No Shinkei Geka. 2000;28:909–912. Japanese.))
((Nogueira K, Liberman B, Pimentel-Filho FR, Goldman J, Silva ME, Vieira JO, et al. hCG-secreting pineal teratoma causing precocious puberty: report of two patients and review of the literature. J Pediatr Endocrinol Metab. 2002;15:1195–1201.))
((Sakurada K, Kayama T, Kawakami K, Saino M, Sato S. A successfully operated case of 
 with recurrent intratumoral hemorrhage. No Shinkei Geka. 2000;28:67–72. Japanese.))
((Kida Y, Banno M, Kanzaki M, Kobayashi T, Kageyama N. Pineal choriocarcinoma presenting massive ventricular hemorrhage--a case report. No Shinkei Geka. 1985;13:641–645. Japanese.))
((Wakai S, Yamakawa K, Manaka S, Takakura K. Spontaneous intracranial hemorrhage caused by brain tumor: its incidence and clinical significance. Neurosurgery. 1982;10:437–444.))
((Fujii T, Itakura T, Hayashi S, Komai N, Nakamine H, Saito K. Primary pineal choriocarcinoma with hemorrhage monitored by computerized tomography. Case report. J Neurosurg. 1981;55:484–487.)).

[[Vascular pineal malformation]] and [[pineal cyst]]s
((Mukherjee KK, Banerji D, Sharma R. Pineal cyst presenting with intracystic and subarachnoid haemorrhage: report of a case and review of the literature. Br J Neurosurg. 1999;13:189–192.))
((Mena H, Armonda RA, Ribas JL, Ondra SL, Rushing EJ. Nonneoplastic pineal cysts: a clinicopathologic study of twenty-one cases. Ann Diagn Pathol. 1997;1:11–18.))
((Vallee B, Meriot P, Dam Hieu P, Person H. Benign hemorrhagic cyst of the pineal region. Treatment by stereotactic puncture. 4-year follow-up. Neurochirurgie. 1997;43:303–307. French.)). 

Various pineal tumors have been reported to cause intra-tumoral hemorrhage including [[ganglioglioma]]
((Tekkok IH, Ventureyra EC. Spontaneous intracranial hemorrhage of structural origin during the first year of life. Childs Nerv Syst. 1997;13:154–165.))
pineocytoma
((Matsumoto K, Imaoka T, Tomita S, Ohmoto T. Pineocytoma with massive intratumoral hemorrhage after ventriculoperitoneal shunt- case report. Neurol Med Chir (Tokyo) 1997;37:911–915.))
[[choriocarcinoma]],
((Nogueira K, Liberman B, Pimentel-Filho FR, Goldman J, Silva ME, Vieira JO, et al. hCG-secreting pineal teratoma causing precocious puberty: report of two patients and review of the literature. J Pediatr Endocrinol Metab. 2002;15:1195–1201.))
((Sakurada K, Kayama T, Kawakami K, Saino M, Sato S. A successfully operated case of choriocarcinoma with recurrent intratumoral hemorrhage. No Shinkei Geka. 2000;28:67–72. Japanese.)) 
meningioma
((Ohba S, Kurisu K, Arita K, Sugiyama K, Inoue T, Satoh H, et al. Falcotentorial meningioma accompanied by temporal lobe hematoma. Hiroshima J Med Sci. 2001;50:75–77.))
and hemangiopericytoma.
((Cervoni L, Artico M, Salvati M, Bristot R, Wierzbicki V, Gagliardi FM. Haemangiopericytoma and meningioma presenting clinically with intracranial haemorrhage: report of three cases and review of the literature. Zentralbl Neurochir. 1993;54:20–23.))
Embryonal carcinoma and metastatic melanoma are also included in the differential diagnosis
((Maruki C, Takara K, Abe K, Tsunoda A, Ebato M, Ikeya F. Primary pineal embryonal carcinoma occurring in a middle aged man. No Shinkei Geka. 2000;28:909–912. Japanese.))
((Vaquero J, Martinez R, Magallon R, Ramiro J. Intracranial metastases to the pineal region. Report of three cases. J Neurosurg Sci. 1991;35:55–57.)).