Neuroglial cyst

Last revised by Yaïr Glick on 9 Feb 2024

Neuroglial cysts (also known as glioependymal cysts and neuroepithelial cysts) are rare, benign epithelial-lined cystic lesions that can potentially occur anywhere in the neuraxis. On imaging, they are characterized as CSF-like parenchymal cysts with smooth, rounded borders and minimal-to-no surrounding signal intensity abnormality. 

They are rare and represent <1% of the intracranial cysts 1.

Neuroglial cysts are congenital lesions that develop a sequestration of neural tube embryonic elements that develop into a fluid-filled cavity, lined by glial cells, and located within the white matter 4

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.

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

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.

General imaging differential considerations include:

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