Tumores en glándula pineal y manifestaciones neuro-oftalmológicas complejas: síndrome de parinaud y pupila de Argyll Robertson Pineal gland tumors and complex neuro-ophthalmological manifestations: parinaud syndrome and Argyll Robertson pupil
Year: 2026
Type: article
Study design: Case Report
Abstract: ABSTRACT Introduction: Pineal gland tumors are primary tumors of the central nervous system (CNS) that typically present during childhood, causing hydrocephalus. This often requires intervention via ventriculoperitoneal shunt (VPS), which can lead to complex neuro-ophthalmological manifestations due to mechanical distortion of the midbrain. In patients with functional systems and no papiledema, these sequelae often go unnoticed, hindering the diagnosis of persistent neurological dysfunctions. General objective: To analyze the complex neuro-ophthalmological manifestations in a pediatric patient with a pineal gland tumor. Methodology: A single-case, descriptive, cross-sectional study with a qualitative-clinical approach. A 15-year-old adolescent with a history of pineal gland tumor complicated by hydrocephalus was evaluated in the immediate postoperative period following ventriculoperitoneal shunt placement. Data were collected using direct clinical observation, biomicroscopy, and fundoscopy. Results: Visual acuity was 20/20, and the classic triad (Parinaud's syndrome) was identified, consisting of vertical gaze palsy, convergence-retraction nystagmus, and light-convergence dissociation (Argyll Robertson pupil). Fundus examination revealed no signs of papilledema, confirming compensated intracranial pressure. Conclusions: The presence of complex Parinaud's syndrome in this patient demonstrates that stabilization of global pressure does not guarantee the resolution of local mechanical distortions in the pretectal region. It is concluded that ophthalmological monitoring should include pupillary motility and reflex testing to detect supranuclear sequelae, regardless of the optic disc's condition.
Source: Revista GICOS
Language: Spanish
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7218309513