Neuroglial cyst [Neurosurgery Wiki]

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====== Neuroglial cyst ======

Neuroglial [[cyst]]s (also known as [[glioependymal cyst]]s and [[neuroepithelial cyst]]s) are rare, benign epithelial-lined [[cystic lesion]]s that can potentially occur anywhere in the [[neuraxis]]. 

[[Choroid plexus cyst]]s (CPCs) are a type of [[neuroepithelial cyst]]s, benign lesions located more frequently in the [[supratentorial]] compartment. Symptomatic CPCs in the [[posterior fossa]] are extremely rare and can be associated with [[obstructive hydrocephalus]].

===== Epidemiology =====

They are rare and represent <1% of [[intracranial cyst]]s.

see [[Posterior fossa neuroglial cyst]].

===== Pathology =====

Neuroglial cysts are congenital lesions that develop a sequestration of neural tube embryonic elements that develop into a glial cell lined, fluid filled cavity, located within the white matter. 
Location

They can be intra- or extra-parenchymal with the former being more common. The frontal lobe is thought to be the most typical location 1,3.

===== Diagnosis =====


On imaging they are characterised as CSF-like parenchymal cysts with smooth, rounded borders and minimal-to-no surrounding signal intensity abnormality. 


====Radiographic features====
===CT===

Typically seen as a well defined, non enhancing, hypodense (CSF density) unilocular cystic lesion with no surrounding oedema. They do not calcify.

=== MRI ===


Neuroglial cysts usually follow CSF signal. Hence they are hypointense on T1 and hyperintense on T2. They do not enhance with gadolinium. They are usually suppressed on T2 FLAIR sequences.

===== Differential diagnosis =====


General imaging differential considerations include:

[[Porencephalic cyst]]: communicates with the lateral ventricle, usually shows surrounding gliosis 
    
    
[[Arachnoid cyst]]: typically extra-axial, enlarged perivascular space, typically multiple cluster around the basal ganglia
    
[[Neurocysticercosis]]: usually <1 cm, partially enhance
    
cerebral hydatid cyst: usually spherical, may be indistinguishable

[[Ependymal cyst]]: periventricular,  may be indistinguishable
    
[[Epidermoid cyst]]: usually does not follow CSF signal in all sequences restricted diffusion