An unusual case of headache.

Pineal gland tumors comprise 0.5%-1% of adult brain tumors. Pineoblastomas constitute less than half of these pineal gland tumors. Due to the key anatomic location, these tumors produce hydrocephalus by pressing on the aqueduct of Sylvius. Headache is a very common symptom. We describe the case of a 20-year-old female who presented with new onset persistent headache. Workup revealed a pineoblastoma. These tumors can be detected by MRI and diagnosed on cytology ofcerebrospinal fluid (CSF) showing blue round tumor cells with specific tumormarkers. Combined chemo radiation therapy is the treatment for these tumors. New onset persistent headaches are present in 50%-60% of intracranial tumors. All new onset persistent headaches should be promptly evaluated.