Intracranial neurenteric cysts (also sometimes spelled neuroenteric) are developmental CNS lesions arising from endoderm.
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.
Iso- to slightly hyper-attenuating compared to CSF with no enhancement.
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
Imaging differential considerations include:
- similar to CSF in signal
- high DWI signal, ADC similar to brain parenchyma
- CSF signal on all sequences
- solid enhancing component
- fat signal on all sequences
- suppression on fat-suppressed sequences
- a stalk-like connection to the clivus
- variable enhancement
- usually enhances following IV contrast
- 1. Gauden AJ, Khurana VG, Tsui AE et-al. Intracranial neuroenteric cysts: a concise review including an illustrative patient. J Clin Neurosci. 2012;19 (3): 352-9. doi:10.1016/j.jocn.2011.10.005 - Pubmed citation
- 2. Wang L, Zhang J, Wu Z et-al. Diagnosis and management of adult intracranial neurenteric cysts. Neurosurgery. 2011;68 (1): 44-52. doi:10.1227/NEU.0b013e3181fc5ee0 - Pubmed citation