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What is a Pineal Cyst?

A pineal cyst is a fluid-filled sac that develops in the pineal gland, a small endocrine gland in the brain. Generally benign, these cysts often present no symptoms and are discovered incidentally during imaging tests. However, when they grow, they can cause headaches or vision disturbances. Intrigued? Explore how these cysts impact health and when intervention might be necessary.
H. Colledge
H. Colledge

A pineal cyst is a fluid-filled growth inside the pineal gland in the brain. In most cases, a pineal cyst is a benign tumor which does not cause any symptoms. Occasionally a cyst may enlarge and press on surrounding structures causing symptoms such as headaches and blurred vision. If this occurs, the cyst can be removed using surgery. The study of the brain and nervous system and the conditions that affect them is known as neurology.

Pineal cysts are usually small in size, with the majority measuring less than 0.39 inches (1 cm), and they are more common in women and people in their 40s. It is thought that they may be associated with changes in hormone levels; the pineal gland is involved in the production and secretion of melatonin, which interacts with reproductive hormones. This type of cyst will usually remain the same size, but a few will shrink and, in rare cases, a cyst will grow large enough to cause symptoms. Head pain, dizziness and vomiting may occur, as well as sight problems such as blurred or double vision and loss of eye movement.

Pineal cysts may cause head pain.
Pineal cysts may cause head pain.

Sometimes a condition known as Parinaud syndrome may develop as a result of an enlarged pineal cyst. Parinaud syndrome has symptoms involving the eyes, with the pupils ceasing to respond to light, although they will still contract normally when an object moves nearer. There are difficulties with moving the eyes to look upward, and irregular, jerky eye movements can occur.

An MRI brain scan may be conducted to diagnose a pineal cyst.
An MRI brain scan may be conducted to diagnose a pineal cyst.

If a mass such as a pineal cyst causes pressure on what is called the cerebral aqueduct, a channel in the brain which connects two fluid-filled spaces known as ventricles, fluid is prevented from flowing freely. This obstruction leads to a condition called hydrocephalus, where fluid can build up and put pressure on the brain. Rarely, this may happen suddenly and prove fatal, but more often there is time to treat the problem surgically.

The pineal gland secretes melatonin, which promotes sleep.
The pineal gland secretes melatonin, which promotes sleep.

This kind of cyst can be seen using a magnetic resonance imaging, or MRI, scan where it appears as a well-defined, oval mass with smooth walls. As these cysts are so common, thought to be present in almost a quarter of adults, any small ones which are not causing symptoms do not generally need any treatment or follow-up scans. Where symptoms are experienced, total removal of a cyst using surgery is necessary. In cases where hydrocephalus persists after the cyst has been removed, a tube known as a shunt can be put in place to drain fluid away from the ventricles.

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Discussion Comments


I was just told I have a 4mm cyst and the nurse, since the specialized neurologist wasn't there, told me that she didn't think it was causing my symptoms. However, I'm having headaches and nausea daily, double vision once a week, occasionally losing the ability to speak correctly as well as problems with my short term memory.

Is this related to the cyst?


I was diagnosed four months ago with a 2.5cm pineal cyst, and shortly after had endoscopic surgery to drain it. I had quite a few symptoms of it: hydrocephalus (my ventricles were over double the normal side), memory loss, speech impediment, intense migraines with vomiting and a constant feeling of being in a daze just from the pressure.

If you are ever faced with the options of surgery or waiting it out, I would choose the surgery over and over again. My surgery went flawlessly, I woke up in minimal pain and was released the next day due to having no neurological effects after the surgery.

I was very fortunate to have two very highly accredited surgeons on my team,which is a lot of help. Living in pain is not something I liked as it just got progressively worse. The cyst was sitting right over the third ventricle where the spinal fluid drains and caused a blockage.

If it had been left as it was, my surgeon told me that I had one or two years left to live and the potential that if it shifted and completely blocked of that drain system it would kill me. Given those stats, I wasn't risking it as it had already grown quite large.

After surgery you will still have headaches, because your tissue is damaged from the pressure and there isn't much you can do about it. In my case, with only having it drained, there is the worry of it refilling and going through the process again. I just have to monitor the headaches and keep track of any symptoms that may arise and how frequent they are.

This was my first surgery and it was scary not knowing the outcome. Though having gone through it and not having any complications, I don't find it as terrifying anymore if I ever have to do it again. Endoscopic surgery does leave you with a nice little pocket in your skull. Use it to your advantage and creep people out.


Two months ago I had my pineal gland cyst surgery.

For me there was no question about that dilemma of which is more scary.


I have a 4mm pineal cyst now for 10 years. It causes me vertigo, irregular heart beats, anxiety, head pressure, sinus pressure and much more. 4mm is a small size but everyone is different and the location is important. Mine caused my life to go upside down. dr hrayr shahinian at cedar senai medical center said it was responsible for all my symptoms but won't operate until it doubles in size. I am in so much pain!


My seven year old had an MRI and was diagnosed with a 6mm pineal cyst. She has been dizzy, at least once a day since January on four different antibiotics for sinusitis (before the MRI).


That sounds like a really scary condition! I guess you can never know exactly what's going on inside your body.

I wonder how many people with migraines actually have them caused by large pineal cysts -- I had heard that there was some kind of connection between the two.

I also wonder how a pineal cyst would affect your pineal eye (third eye). That would just be devastating to people who often meditate or use their third eye for divination. Has anyone experienced something like this, can you tell me what kind of effects it has?


Is a pineal cyst in any way similar to a sub arachnoid cyst? My sister in law had one of those sub arachnoid cysts, and the only thing I can remember about it is we kept telling her that it sounded like she had a spider in her brain.

Now I don't even remember if it was something to do with a gland, like the pineal cyst, or something completely different. Are the pineal cyst symptoms anything like those of an arachnoid cyst? I do remember something about hydrocephalus being one of the symptoms of arachonid cysts, and you mentioned that it was also a pineal cyst symptom. Do they share any other symptoms?

I would love to learn more about this -- I got really interested in tumors and stuff like that when Margy had her cyst removed. Can you tell me a little more?


I wonder how many people go through life with a small pineal cyst and don't even realize that it's there?

I guess that's one of the great things about those full-body MRI scans that they offer now -- you can see everything that's going on in there and prevent bad things from happening.

Although in the case of a pineal gland, I really don't know what I would do. I mean, if my scan showed a large pineal cyst, then of course I'd get it taken of the gland, but if it was a small one... I really don't know. It would come down to deciding which one was more scary, brain surgery or a pineal cyst! What would you guys do?

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    • Pineal cysts may cause head pain.
      By: Andrzej Wilusz
      Pineal cysts may cause head pain.
    • An MRI brain scan may be conducted to diagnose a pineal cyst.
      By: beerkoff
      An MRI brain scan may be conducted to diagnose a pineal cyst.
    • The pineal gland secretes melatonin, which promotes sleep.
      By: Ariwasabi
      The pineal gland secretes melatonin, which promotes sleep.
    • A pineal cyst can cause headaches and vision problems.
      By: Andy Dean
      A pineal cyst can cause headaches and vision problems.
    • The symptoms of a pineal cyst may include blurry vision.
      By: bellemedia
      The symptoms of a pineal cyst may include blurry vision.