E4523. Like a Hole in the Head: Intracranial Cysts
  1. Adam Dykie; University of Rochester
  2. Mohammad Syed; University of Rochester
  3. Alexander Kessler; University of Rochester
  4. Akm Rahman; University of Rochester
Intracranial cysts are common findings in brain imaging with a variety of etiologies and sequelae. They may present with nonspecific symptoms or even be discovered incidentally. Differential diagnoses of cysts may vary by the location in the brain, and specific imaging features often aid in differentiating lesions, especially those that are benign versus malignant. Understanding these etiologies and imaging findings provides a basis for further management of the lesion.

Educational Goals / Teaching Points
This educational exhibit will provide an overview of the basic etiologies of different intracranial cystic lesions. It will review the characteristic anatomic locations and imaging features. It will also present a compilation of cases with an emphasis on differentiating features. This will help one differentiate intracranial cysts with worrisome features requiring immediate attention from more benign cystic lesions. Basic management will also be addressed.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
MRI and CT are useful in characterizing intracranial cystic lesions. Different types of cysts may have different properties noted on MRI sequences including include T1, T2, and DWI. Other features on imaging such as contrast enhancement, calcification, or the absence of these features may be helpful as well. Different cysts may also have characteristic anatomic locations which can be used in tandem with imaging features to aid in diagnosis.

Intracranial cysts have a variety of different etiologies including neoplastic, infectious, and developmental, often with varied patient presentations. Anatomic location is often helpful with differential diagnosis in tandem with imaging features. Specific imaging features including enhancement, diffusion restriction, and calcification may be helpful in distinguishing different types of lesions, especially benign and malignant lesions. This can guide further management including follow up imaging and surgical intervention. In unclear cases, biopsy and subsequent pathology may be required.