Pineal Gland Apoplexy, Case Presentation with Review of the Literature: Is There a Preferred Entry Point for Endoscopic Treatment of Pineal Apoplexy?

Kawtharani S, Horanieh E, Ali B, Amine M, Housheimy ME and Darwich H

Department of Neurosurgery, American University of Beirut Medical Center, Lebanon Department of Surgery, University of Balamand, Lebanon University of Balamand, Lebanon

^*Correspondance to: Houssein Darwich 

 PDF  Full Text DOI: 10.25107/2474-1647.3712

Abstract

Introduction: Pineal apoplexy is defined as hemorrhage into the pineal gland that can be accredited to pineal cysts, tumors, or arteriovenous malformations. Although there are several etiologies, they share the same clinical manifestations of headache, gaze paresis, nausea and vomiting, acute obstructive hydrocephalus, and even death. Pineal apoplexy is a neurologic emergency and therefore an immediate surgical intervention to relieve the pressure of the mass effect caused by the hydrocephalus is necessary. Case Description: We present the case of a 6 years old female patient who presented to us with signs of increased intracranial pressure. Work up including MRI brain showed pineal apoplexy with obstructive hydrocephalus. Surgical intervention was done including ETV (Endoscopic Third Ventriculostomy) and biopsy of the lesion. According to our practice, we utilized a single-entry point that provides access to the ETV site and that also allowed us to access the pineal region for biopsy. Conclusion: Being a rare pathology, pineal apoplexy requires urgent treatment due to the obstructive hydrocephalus caused by the lesion. In this paper we present the case of a 6-year-old female patient who presented with obstructive hydrocephalus due to pineal apoplexy that was treated with ETV and biopsy of the lesion. In this paper we are the first to suggest new measurements to be taken when treating pineal apoplexy endoscopically in order to have one ideal entry point that can serve as a good trajectory to both the pineal region and the site of ETV.

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Cite the article

Kawtharani S, Horanieh E, Ali B, Amine M, Housheimy ME, Darwich H. Pineal Gland Apoplexy, Case Presentation with Review of the Literature: Is There a Preferred Entry Point for Endoscopic Treatment of Pineal Apoplexy?. Clin Surg. 2024; 9: 3712..