A Case Report of Pineal Germinoma Apoplexy

1.1. Background Pineal apoplexy is a condition related to the pineal gland of the brain, characterized by bleeding within this region. The bleeding can be caused by various factors, including pineal cysts, tumors, or abnormal blood vessels near the pineal area. Intracranial germinomas (GN), rare types of tumors that typically start in children, can also be a factor. 1.2. Case Presentation A 16-year-old boy who had previously been diagnosed with a pineal gland tumor (Germinoma) and was undergoing chemotherapy presented to our hospital with complaints of headache and diplopia. The patient has past history of intra ventricular CSF diversion to relive high intracranial tension. An urgent CT scan revealed a soft tissue mass in the pineal region, accompanied by supraventricular hydrocephalus, intraventricular hemorrhage, and CSF seeding. The patient's Glasgow Coma Scale (GCS) was 10, and he was admitted to the ICU for observation due to deteriorating vital signs. 1.3. Methods Urgent brain CT was done with multi–detector row scanners. Multi–detector row CT images were acquired in four simultaneous 2.5-mm-thick sections, which were combined in projection space to create two contiguous 5-mm-thick sections. Axial, sagittal and coronal reconstructions non contrast CT was done. 1.4. Results CT scan showed a soft tissue density mass in the pineal region with hyperdense areas near the septum pellucidum and the ipsilateral right lateral ventricles. Supratentorial hydrocephalus with ependymal spread in both lateral ventricles was also detected. 1.5. Objectives Imaging techniques like CT and MRI play a crucial role in identifying the specific cause of the pineal apoplexy.