Open lip schizencephaly | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Open lip schizencephaly

Coronal FLAIR (image 1) and axial T2-weighted (image 2) MRI show a large, open-lipped schizencephaly (arrow) accompanied by a bifrontal arachnoid cyst (arrowhead) and absence of the septum pellucidum. Schizencephaly can be differentiated from porencephalic cysts by the presence of gray matter lining the cleft. The term 'open-lipped' describes when the cleft walls are separated and filled with cerebrospinal fluid.

Similar cases

Sagittal (image 1) and axial (image 2) T2-weighted MRI show a Rathke cleft cyst (arrow) extending into the sella turcica. Rathke cleft cysts arise from epithelial remnants between the anterior and posterior lobes of the pituitary gland. While most are small and asymptomatic, larger cysts may compress adjacent structures causing headaches, endocrine dysfunction, and visual disturbances.

Axial T2 (image 1) and inversion recovery (image 2) MRI shows an open lip schizencephaly (arrow) of the right temporal lobe. Schizencephaly is a neuronal migration disorder. It can be categorized as either open or closed lipped. An open lip schizencephaly occurs when there is communication of the cleft with the ventricular system. Schizencephaly is differentiated from porencephaly by presence of gray matter lining the cleft.

RATHKE'S CLEFT CYST - Rathke's cleft cysts, also known as pars intermedia cysts, are nonneoplastic, sellar or suprasellar epithelium-lined cysts arising from the embryologic remnants of Rathke's pouch in the pituitary gland. They are common lesions and usually incidentally identified. 👉🏼Radiographic features- On imaging, a Rathke's cleft cyst is seen as a well defined non-enhancing ,commonly a midline cyst within the sella arising between the anterior and intermediate lobes of the pituitary. 40% are purely intrasellar and 60% have suprasellar extension.

Sagittal T1 (Image 1) and T2 FIESTA (Image 2) MRIs reveal an isointense lesion at the foramen of Monro, consistent with a colloid cyst. These benign lesions have an epithelial lining and are filled with materials like mucin, old hemorrhage, cholesterol, and ions. Patients might experience symptoms such as headaches, double vision, and vertigo. In rare cases, colloid cysts can precipitate sudden death by causing acute obstructive hydrocephalus.