Pineal Cyst

[purity210]

I have had constant headaches for over 10 years now and was recently diagnosed with a pineal cyst. The size they measured it to be was 1.3 cm by 8mm. I know this is a bit bigger than what they are normally seen at. I have daily headaches...usually worse at night. Trouble falling asleep and staying asleep, usually do to the headaches that I have at night. I get migraine headaches at least once a week and have some visual disturbances. For example, I can place by hand on my forehead at a right angle with my body and when I look up, I can't see it. I have been put on Midrin, Darvocet, Maxalt, Inderal, Fioricet and anti-inflammatory medications and nothing has worked. I have seen a neurologist who says the cyst is nothing and thinks I am having tension headaches. He put me on an anti-depressant (the name of which I can't remember) that is designed for tension headaches and it did nothing. I was wanting to know when a cyst can cause symptoms such as headaches?

[Vanessa Lacuesta]

Hi,

"Patients with symptomatic pineal cysts most often present with one of three syndromes: 1) paroxysmal headache with gaze paresis; 2) chronic headache, gaze paresis, papilledema, and hydrocephalus; or 3) pineal apoplexy with acute hydrocephalus."

Source:http://www.ncbi.nlm.nih.gov/pubmed/1432132?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus

Gaze paresis refers to abnormal eye movements. Papilledema refers to an eye finding due to increase intracranial pressure.Pineal apoplexy refers to bleeding . I do not mean to alarm you with this but  I do suggest that you seek second opinion for your condition.

At this point, I feel that your headaches may still have a migraine headache or tension headache component. However, I do understand that this worries you. A second opinion will be essential since pineal cysts that have an increase likelihood to be symptomatic need to be surgically removed.

[purity210]

I don't have any of the normal associated symptoms...such as sensitivity to light and nausea and all that.

I do notice when my headaches get really bad my eyes "jump" to the point where I can't focus on anything...it all blurs. My arms will go numb and tingly.

I have been to a neuro-opthamologist who says my vision range is normal and says it sounds like I'm having migraines and placed me on the Inderal...but it didn't do a thing. I still have headaches everyday. I literally wake up in the morning with them.

I know that everything I've read says that pineal cysts are normally asymptomatic....but it says that for cysts that are small. Usually .5cm and smaller....mine is double that size.

What would be the symptoms of the cyst having a "mass effect on nearby structures"?

[Vanessa Lacuesta]

Hi,

Pineal cysts are usually asymptomatic unless they are large enough to cause symptoms. In your case, you have been having the headaches for the past ten years and there were no other associated symptoms that came with the headaches ( is this correct?).

Have your eyes evaluated by an opthalmologist. Are there any other symptoms present now like increase in headache severity, doubling of vision, vomiting or weakness of the extremities?

Pineal cyst may enlarge and cause some mass effect on nearby structures. However, this doesn't seem to be your case based on your symptoms. I suggest that you discuss this with your physician so that further evaluation may be done . You may ask if the cyst needs to be radiographically monitored in the next few months.

To allay your worries, you may seek second opinion. Bring your scan results with you during consultations.