Symptomatic pineal cyst

Although pineal cysts are incidental findings in as many as 1,4 - 4,3% of magnetic resonance imaging studies, symptomatic pineal cysts are quite rare because pineal cysts cannot be detected until they reach to a size that can cause compression symptoms. We present a case of symptomatic pineal cyst with complaints of mental dullness and headache for the last three years. His neurological examination revealed only bilateral upgaze palsy. CT and MRI scanning showed a regionally calcified cystic tumour at the pineal region with 1,5 cm in diameter which was thought to be the reason of Parinaud's syndrome. UGA, sitting position, by supratentorial suboccipital approach the cystic lesion was totally extirpated. Histological examination confirmed the diagnosis of a pineal cyst. Asymptomatic incidental cases do not require treatment but if there are neurological findings usually those that are more than 1,5-2 cm diameter then the cyst must be totally extirpated surgically.