Nocturnal headache and fear of not awakening

Pineal gland cysts usually asymptomatic are usually an incidental finding on imaging performed for another reason. They have occasionally been associated to various symptoms such as headache, seizures or mental disorders, being its size or the presence of intracystic bleeding the most important risk factors for becoming symptomatic.

We report the case of a 14 years old woman with a small pineal cyst with intracystic bleeding that refers changes in the characteristics of her usual headache and psycho-affective manifestations.