"Rubral" tremor following radiation of a pineal region vascular hamartoma.

Tumours of the pineal region have historically been difficult to remove safely. Only recently have large series of successful pineal area operations been reported, and there are many advocates for surgical reticence with these tumours. We report a case of a 20-year-ol women whose pineal region tumour was irradiated, whereupon a unilateral low-frequency resting and intention tremor developed. Following resection of the lesion, a vascular hamartoma, the tremor virtually disappeared. We believe the tremor was secondary to radiation induced tumour shrinkage and distortion of the mesencephalon. This case is demonstration of the importance of exploration and histological verification of pineal region tumours.