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Headaches and Pineal Cysts

CASE This is a 27-year-old man with migraines without aura for about 15 years that have increased in frequency to about twice a week in the last 1 year. The headaches are relieved within 1 hour by a triptan. Neurological examination was normal. Family history reveals that both parents, his brother, and sister are all migraineurs.A magnetic resonance imaging (MRI) of the brain obtained at the patient’s request revealed a 6-7 mm pineal cyst without mass effect. Questions: What is the natural history of pineal cysts? When are follow-up MRI scans indicated? Are pineal cysts associated with migraines?