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Central Nervous System Cyst

A central nervous system cyst is a cyst that primarily presents itself in the tissue of the central nervous system.They are usually benign and could be filled with cerebrospinal fluid, blood, or tumor cells. There are two categories; cysts that originate from non-central nervous system tissues, and cysts that originate from central nervous system tissues.

Classification

 Originating from non-central nervous system tissues

This classification of cysts are embedded in the endoderm and the ectoderm of cranial and spinal cord germ layers. They normally take over the neuraxis, which allows them to infiltrate the central nervous system tissues.They are most commonly found in the area near the pineal gland, the supracellar cistern, and the cerebelloponitine angle space. Some examples include Teratomas, dermoid cysts, and Rathke’s cleft cysts.

Originating from the central nervous system tissues

This category of cysts takes over areas of necrotic tissue in the brain from injuries, diseases, or abnormalities, which will happen due to the central nervous systems nonregenerative nature. These cysts can affect all germ layers of the central nervous system, but are most common in the arachnoid mater, and the ventricular space. Some examples are arachnoid cysts, ependymal cysts, cystic cerebellar astrocytomas

Signs and symptoms

Some of the cysts can be asymptomatic depending on the location in the brain or spinal cord. If the cysts do develop into critical areas of the central nervous system they will present the following symptoms:

• pressure in the spinal cord or brain  
• Rupture of nerves around the cyst
• Weakness in area controlled by brain affected by the cyst
• Inflammation
• Can be asymptomatic depending on type and location of cyst
• Hydrocephalus
• Brainstem hemorrhage

Symptoms tend to vary depending on the type of cyst as well as the location, and are assessed on a case by case basis.

Causes

Many brain cysts form in the womb during the first few weeks of development as a result of congenital defects.  Cyst may also form later in life due to a head injury or trauma, and sometimes can be associated with cancerous tumors or infection(s) in the brain. However for the most part, the underlying reason(s) for cyst formation are still unknown.

Diagnosis

Healthcare professionals will typically diagnosis a brain cyst via an imaging scan/test. These imaging tests include CT scans and MRIs. The diagnosis process typically begins with a medical history workup followed by a medical exam. In some cases a primary health care provider will refer a patient to a neurologist or neurosurgeon. Other diagnostic methods include the usage of Immunohistochemistry, used to differentiate between epithelial and and arachnoid cysts, and radiological and macroscopic examinations. These examinations are useful to get a baseline idea, but can be unsatisfactory to diagnosis CNS cysts.

Classification

 Ordinary cysts found in different regions of the body, not including the central nervous, are classified depending on how they look under a microscope. As of 2016 the World Health Organization (WHO) announced genetic testing would be used to further classify cysts found in the CNS.  Further understanding of a cysts genetic makeup will shed further light on how to treat cysts.