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 tumors 1) 2) 3) 4) 5) 6) 7).

Vascular pineal malformation and pineal cysts 8) 9) 10).

Various pineal tumors have been reported to cause intra-tumoral hemorrhage including ganglioglioma 11) pineocytoma 12) choriocarcinoma, 13) 14) meningioma 15) and hemangiopericytoma. 16) Embryonal carcinoma and metastatic melanoma are also included in the differential diagnosis 17) 18).

1)
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.
2) , 17)
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.
3) , 13)
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.
4)
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.
5)
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.
6)
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.
7)
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.
8)
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.
9)
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.
10)
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.
11)
Tekkok IH, Ventureyra EC. Spontaneous intracranial hemorrhage of structural origin during the first year of life. Childs Nerv Syst. 1997;13:154–165.
12)
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.
14)
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.
15)
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.
16)
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.
18)
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.