A pineal region meningioma presenting with acute subarachnoid hemorrhage: a case report and literature review

Abstract Background The primary aim of this study is to present a rare case of a pineal meningioma that presented with subarachnoid hemorrhage. Case presentation A 54-year-old male patient presented with a headache but no other neurological symptoms. He had experienced a sudden severe headache, memory impairment, loss of consciousness, and vomiting 13 days prior, leading to his admission to the ICU where he was diagnosed with subarachnoid hemorrhage. Upon arrival at the Pioneer Doctors Center, the patient exhibited slightly elevated blood pressure but showed no significant neurological deficits. He was cooperative, conscious, and oriented, scoring 15/15 on the Glasgow Coma Scale. His medical history included occasional headaches over the past 6 months. Imaging studies, including brain CT angiography and MRI, revealed a well-defined mass in the pineal region, compressing nearby structures. The patient underwent a right occipital interhemispheric transtentorial approach for tumor resection. Post-surgery, he experienced blurred vision but no neurological deficits. His condition improved significantly, and he was discharged two days later. Histopathological analysis confirmed a spindle cell tumor without atypia or necrosis, indicating a benign nature. Fourteen articles were found on PubMed. After excluding two non-English articles, 12 were screened, but none mentioned "meningioma" indicating a lack of relevant literature. Conclusion Pineal tumors can present with subarachnoid hemorrhage, and surgical resection yielded a favorable outcome.