Pineal glands tumours are a diverse group of neoplasms. The most common is a germ cell tumour, which arises from residual embryonic tissue in the gland. It presents with the classical symptoms of a space occupying lesion – headache, nausea and vomiting. The tumour can also cause Parinaud syndrome – inability to move the eyes upwards – this is due to compression of the superior colliculi. In addition, obstruction of the cerebral aqueduct may produce hydrocephalus. In children, a pineal gland tumour (which invades and destroys the gland), produces an accelerated onset of puberty. Thus, it is thought that one of the functions of the gland is to inhibit sexual development.