Neuroglial cyst

Case contribution: Dr Radhiana Hassan


  • A 29 years old lady
  • Migraine since 15 years old under neuromedical follow up
  • Depression under psychiatry follow up
  • Presented with blurring of vision and headache x 1 year
  • Clinical examination: normal
  • Opthalmology assessment: low myopia, no other abnormality

MRI findings:

  • A well-defined lesion in the white matter of left temporal lobe (red arrow).
  • The lesion is hypointense on T1-weighted image (A), hyperintense on T2-weighted image (B), not enhanced post contrast (C) and fully suppressed on FLAIR (D).
  • No expansion of the cortex is seen. No mass effect. No volume loss.
  • No extension to ventricles. No surrounding sclerotic rim.
  • No other lesion in the brain.

Differential diagnosis:

  • Neuroglial cysts
  • Porencephalic cyst: communicates with lateral ventricle, usually shows surrounding gliosis
  • Enlarged perivascular space: typically multiple, clusters in basal ganglia
  • Neurocysticercosis: partially enhance, presence of central hyperintensity
  • Cerebral hydatid cyst: usually large, may be indistinguishable
  • Ependymal cyst: periventricular
  • Epidermoid cyst: do not follow CSF in all sequence, restricted diffusion, usually at CPA/sellar

Diagnosis: Neuroglial cyst (no HPE)


  • Neuroglial cyst is also known as glioependymal cyst.
  • Benign, glial-lined, fluid containing cavity within the cerebral white matter
  • may occur anywhere throughout the brain, frontal lobe is most common
  • size varies from a few mm up to several cm
  • no calcification
  • signal intensity similar to CSF, does not restrict on DWI
  • no enhancement
  • minimal or no surrounding signal abnormality

Patient progress:

  • Patient is under conservative management.
  • No surgical intervention done.
Author: radhianahassan