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After close monitoring given the risk of secondary hydrocephalus, the patient was discharged in stable condition with symptom resolution and without any further significant complications. This case report highlights the importance of identifying subtle clinical findings and the risk of secondary haemorrhage of pineal cysts when on anticoagulation. While the risk of secondary hydrocephalus is a significant concern, clinically stable patients can be followed without need for neurosurgical intervention.<\/jats:p>","DOI":"10.1136\/bcr-2019-233469","type":"journal-article","created":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T17:16:10Z","timestamp":1600103770000},"page":"e233469","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Isolated convergence-retraction nystagmus secondary to intralesional haemorrhage of a pineal cyst: an easily missed neurological finding with potentially life-threatening consequences"],"prefix":"10.1136","volume":"13","author":[{"given":"Kristine","family":"Woodward","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amith","family":"Sitaram","sequence":"additional","affiliation":[{"name":"University of Glasgow, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4799-1265","authenticated-orcid":false,"given":"Steven","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,9,14]]},"reference":[{"key":"2025082800373370000_13.9.e233469.1","doi-asserted-by":"crossref","unstructured":"Leigh RJ , Zee DS . 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