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However, the authors reported the case of a primary ICC originating in the pineal gland presenting with recurrent thalamic hemorrhage and displaying an aggressive postoperative clinical course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 41-year-old man arrived at the emergency department with morning headaches and recurrent syncope that had lasted several months. Computed tomography and magnetic resonance imaging (MRI) revealed a pineal gland mass causing obstructive hydrocephalus and a subacute hematoma in the right thalamus. Three weeks after an endoscopic third ventriculostomy was performed, recurrent hemorrhage was observed in the right thalamus. The tumor was promptly removed surgically. The yellowish-white tumor did not exhibit abundant bleeding. No evidence of intratumoral hemorrhage around the hematoma pocket was found. Histopathological examination revealed the characteristics of a chordoma with minimal vascularity. MRI performed 10 weeks postoperatively for worsening headaches revealed abnormal enhancement of multiple cranial nerves, suggesting leptomeningeal seeding (LMS) of the tumor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Despite radiotherapy and intrathecal chemotherapy, the patient\u2019s neurological status worsened; he died 2 years postoperatively. A pineal ICC may cause recurrent thalamic hemorrhage and potentially fatal LMS, even in the early postoperative period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case21110","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T03:01:31Z","timestamp":1624244491000},"source":"Crossref","is-referenced-by-count":1,"title":["Management challenges associated with a pineal region chordoma: illustrative case"],"prefix":"10.3171","volume":"1","author":[{"given":"Ji-Eyon","family":"Kwon","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"So Young","family":"Ji","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kihwan","family":"Hwang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyu Sang","family":"Lee","sequence":"additional","affiliation":[{"name":"Pathology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gheeyoung","family":"Choe","sequence":"additional","affiliation":[{"name":"Pathology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chae-Yong","family":"Kim","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung Ho","family":"Han","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Neurosurg Clin N Am","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.nec.2015.03.012","article-title":"Chordomas: a review","volume":"26","author":"George B","year":"2015","unstructured":"George B, Bresson D, Herman P, Froelich S. 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