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  • Question: I am 25 years old and have suffered with migraines for several years. Recently, my migraines changed along with my symptoms. For example, my vision, I cannot stop the shaking in my hands, lightheaded, slurred speach, etc. In January, I went in for a MRA without contrast and a 1.2 cm pineal lesion was identified. I went back two weeks later for a MRI with contrast and they found a well-defined, smoothly marginated 1.3 cm homogeneous cystic area identified in the region of the pineal gland. They said that the findings most likely represent a pineal cyst with some residual pineal tissue that is causing the enhancement. They also found that I have sinus disease. When I went to a neurosurgeon, I was told that the findings were incidental and that I have had the lesion since birth. I have had multiple MRIs and nothing was ever found before. He told me if my headaches change in 5 to 10 years to have another test done. I cannot wait that long. I am lucky that I still have my job. I have missed so much work, plus I have two young boys who are a hand full and it is very hard for me to take care of them when I have a migraine for 5 days and end up in the hospital. I have alot of questions and it seems like I just get brushed off. Could this be causing my migraines? Is it dangerous? Is this something that will require surgery?
  • Answer:04/07/2004
    I have not seen the scans so this answer is based on your description. Pineal cysts are usually incidental as yours sounds. They are not causing the migraines and are very unlikely to require surgery. A pineal cyst is not dangerous.

    Arno Fried, MD, FACS Chairman, Dept. of Neurosurgery Hackensack University Medical Center Hackensack, New Jersey
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