Intracranial neurenteric cyst

Last revised by Frank Gaillard on 26 Apr 2022

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 1-3:

  • T1: variable signal intensity; iso- to hyperintense to CSF
  • T2: variable signal intensity; hyper- to hypointense to CSF
  • FLAIR: does not suppress
  • DWI/ADC: facilitated diffusion

Imaging differential considerations include:

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