Imaging of congenital and developmental cystic lesions of the brain: a narrative review

ABSTRACT

Introduction

Congenital and developmental intracranial cysts represent a large heterogenous group with varied presentations and etiologies. They can range from normal variants to pathologic lesions often associated with known congenital syndromes or acquired insults. While some are incidentally found, others are symptomatic or may become symptomatic over time. The preferred type of neuroimaging for timely diagnosis helps determine appropriate management and treatment, if indicated.

Areas covered

In this narrative review article, authors present a comprehensive description of developmental cystic lesions. Imaging descriptions are provided for each type of cystic lesion as well as several representative images.

Expert opinion

As advanced neuroimaging techniques become more ubiquitous in clinical use, more light may be shed on the natural history of certain intracranial cystic lesions throughout the lifespan. This includes prenatal imaging for early identification and prognostication to surveillance imaging into advanced age to ascertain associations of certain cystic lesions with age-related cognitive dysfunction.

KEYWORDS:

• Intracranial cyst
• MRI
• arachnoid cyst
• encephaloclastic cystic lesions
• cystic developmental anomalies
• posterior fossa cystic malformations
• perivascular spaces
• Virchow-robin spaces

Article highlights

• Congenital and developmental intracranial cysts are often discovered incidentally.

• Some developmental intracranial cystic lesions are the result of malformations, while others are often the result of infection/injury sustained in utero.

• Developmental cystic lesions range from benign anatomic variants to potentially progressive lesions that require screening.

• Common sequelae occur from cyst growth involving mass effect from compression of adjacent structures and hydrocephalus.

• Appropriate neuroimaging is essential for accurate diagnosis to determine appropriate management.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

We appreciate Dr. Bindu Setty for contribution of the holoprosencephaly images.

Additional information

Funding

This paper was not funded.