Choroidal fissure cyst
Updates to Article Attributes
Choroidal fissure cysts, also known as choroid fissure cysts, are benign intracranial cysts occurring within the choroidal fissure. They are therefore a location-based diagnosis rather than a distinct pathological entity.
Clinical presentation
They are usually asymptomatic and discovered incidentally. Very rarely, they may cause seizures due to mass effect on the temporal lobe 3.
Pathology
Choroidal fissure cysts may represent either neuroepithelial cysts (including neuroglial or glioependymal cysts) 2,6 or arachnoid cysts, although reports of pathologic confirmation are scant.
Radiographic features
They are usually small and range around about 1-2 centimeters in diameter. Occasionally, larger cysts may be seen. The cysts are usually round on axial and coronal images, with a characteristic spindle or ovoid shape paralleling the long axis of the temporal lobe and choroid fissure on sagittal images.
CT
CT scans show a well-delineated homogeneous low density mass with attenuation characteristics similar to CSF. Calcification and contrast enhancement are absent.
MRI
MR signal characteristics are similar to CSF on all sequences. The cyst walls are thin. Contrast enhancement, surrounding oedema and gliosis are absent.
Treatment and prognosis
They are almost always benign with interval follow up (not required) showing no imaging changes. As such no treatment is required 1.
Differential diagnosis
General imaging differential considerations include
-<p><strong>Choroidal fissure cysts</strong>, also known as <strong>choroid fissure cysts</strong>, are benign intracranial cysts occurring within the <a href="/articles/choroidal-fissure">choroidal fissure</a>. They are therefore a location-based diagnosis rather than a distinct pathological entity.</p><h4>Clinical presentation</h4><p>They are usually asymptomatic and discovered incidentally. Very rarely, they may cause seizures due to mass effect on the temporal lobe <sup>3</sup>.</p><h4>Pathology</h4><p>Choroidal fissure cysts may represent either neuroepithelial cysts (including neuroglial or glioependymal cysts) <sup>2,</sup><sup>6</sup> or arachnoid cysts, although reports of pathologic confirmation are scant.</p><h4>Radiographic features</h4><p>They are usually small and range around about 1-2 centimeters in diameter. Occasionally, larger cysts may be seen. The cysts are usually round on axial and coronal images, with a characteristic spindle or ovoid shape paralleling the long axis of the temporal lobe and choroid fissure on sagittal images.</p><h5>CT</h5><p>CT scans show a well-delineated homogeneous low density mass with attenuation characteristics similar to <a href="/articles/cerebrospinal-fluid-1">CSF</a>. Calcification and contrast enhancement are absent.</p><h5>MRI</h5><p>MR signal characteristics are similar to CSF on all sequences. The cyst walls are thin. Contrast enhancement, surrounding oedema and gliosis are absent.</p><h4>Treatment and prognosis</h4><p>They are almost always benign with interval follow up (not required) showing no imaging changes. As such no treatment is required <sup>1</sup>.</p><h4>Differential diagnosis</h4><p>General imaging differential considerations include</p><ul><li>a solitary <a href="/articles/perivascular-spaces">enlarged perivascular space</a>-</li></ul>- +<p><strong>Choroidal fissure cysts</strong>, also known as <strong>choroid fissure cysts</strong>, are benign intracranial cysts occurring within the <a href="/articles/choroidal-fissure">choroidal fissure</a>. They are therefore a location-based diagnosis rather than a distinct pathological entity.</p><h4>Clinical presentation</h4><p>They are usually asymptomatic and discovered incidentally. Very rarely, they may cause seizures due to mass effect on the temporal lobe <sup>3</sup>.</p><h4>Pathology</h4><p>Choroidal fissure cysts may represent either neuroepithelial cysts (including neuroglial or glioependymal cysts) <sup>2,</sup><sup>6</sup> or arachnoid cysts, although reports of pathologic confirmation are scant.</p><h4>Radiographic features</h4><p>They are usually small and range around about 1-2 centimeters in diameter. Occasionally, larger cysts may be seen. The cysts are usually round on axial and coronal images, with a characteristic spindle or ovoid shape paralleling the long axis of the temporal lobe and choroid fissure on sagittal images.</p><h5>CT</h5><p>CT scans show a well-delineated homogeneous low density mass with attenuation characteristics similar to <a href="/articles/cerebrospinal-fluid-1">CSF</a>. Calcification and contrast enhancement are absent.</p><h5>MRI</h5><p>MR signal characteristics are similar to CSF on all sequences. The cyst walls are thin. Contrast enhancement, surrounding oedema and gliosis are absent.</p><h4>Treatment and prognosis</h4><p>They are almost always benign with interval follow up (not required) showing no imaging changes. As such no treatment is required <sup>1</sup>.</p><h4>Differential diagnosis</h4><p>General imaging differential considerations include</p><ul>
- +<li>a solitary <a href="/articles/perivascular-spaces">enlarged perivascular space</a>
- +</li>
- +<li><a title="Hippocampal sulcus remnant cyst" href="/articles/hippocampal-sulcus-remnant-cyst">hippocampal sulcus remnant cysts</a></li>
- +</ul>
Image 14 MRI (T2) ( create )
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