Intracranial neurenteric cyst

Intracranial neurenteric cysts (also sometimes spelled neuroenteric) are developmental CNS lesions arising from endoderm.

Pathology

They result from incomplete resorption of the neurenteric canal, a temporary connection between the yolk sac and amnion during early embryogenesis. Intracranial neurenteric cysts are extra-axial and in 80% of cases are in the posterior fossa anterior to the pontomedullary junction and 20% in the supratentorium adjacent to the frontal lobes. Intracranial neurenteric cysts are much less common than spinal neurenteric cysts.

Radiographic features

CT

Iso- to slightly hyper-attenuating compared to CSF with no enhancement.

MRI

MRI is the modality of choice, and appearances depend on the variable protein content:

  • T1: iso to hyperintense to CSF
  • T2: hyperintense to CSF
  • FLAIR: does not suppress
  • DWI/ADC: facilitated diffusion

Differential diagnosis

Imaging differential considerations include:

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