Neuroglial (also called glioependymal) cysts are benign epithelial-lined lesions that occur anywhere in the neuraxis . They are uncommon, representing fewer than 1% of intracranial cysts. While they may occur in myriad locations, the frontal lobe is the most typical location. Also, intraparenchymal neuroglial cysts are more common than extraparenchymal cysts.

Intraparenchymal neuroglial cysts are congenital lesions, arising from embryonic neural tube elements that become sequestered within the developing white matter. They are rounded, smooth, and unilocular and contain clear fluid that resembles CSF. They are lined by ependymal (columnar epithelium) or choroid plexus cells (low cuboidal epithelium).

The best diagnostic clue to a neuroglial cyst is a nonenhancing CSF-like parenchymal cyst with minimal to no surrounding signal intensity abnormality. The cysts are benign-appearing lesions with smooth, rounded borders. Size is variable.

Other lesions that may be mistaken for a neuroglial cyst include an enlarged PVS(perivascular space), infectious cyst, porencephalic cyst, and arachnoid cyst. Enlarged PVSs are typically multiple and cluster around the basal ganglia. Infectious cysts, such as neurocysticercosis, are typically smaller than 1 cm and can partially enhance. Porencephalic cysts communicate with the lateral ventricle and show surrounding gliosis. Arachnoid cysts are typically extraaxial (11).