• Dylan Goehner, Dallas Soyland, Shawn Vuong, and Eric Trumble.
• Division of Neurosurgery, Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota, USA. Electronic address: Dylan.Goehner@coyotes.usd.edu.
• World Neurosurg. 2020 Oct 1; 142: 159-166.

BackgroundPineal cysts are common, typically asymptomatic, and are usually found incidentally in adults. In rare cases, pineal cyst apoplexy occurs as a result of an acute cystic hemorrhage. This situation can result in acute onset of severe headaches, acute obstructive hydrocephalus, mass effect on the midbrain, and even death. Pineal apoplexy is most common in women of reproductive age, whereas pediatric cases continue to be less prevalent. Pineal cyst apoplexy remains a rare entity with ≥30 cases presented in the literature to date.Case DescriptionWe present the youngest case in the literature (an 8-year-old girl with a pineal cyst that resulted in apoplexy), her diagnostic workup, management, and follow-up. We supplement our case study with a literature review of pineal cyst apoplexy.ConclusionsPineal cyst apoplexy remains a rare clinical event in the pediatric population. Our case details the diagnosis and management of an 8-year-old girl with pineal cyst apoplexy. We also discuss our findings from our literature search for all reported cases of pineal cyst apoplexy.Copyright © 2020 Elsevier Inc. All rights reserved.

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