Neurenteric Cyst

A neurenteric cyst (also known as enterogenous cyst) is a rare congenital malformation that results from the abnormal persistence of the neurenteric canal, a temporary embryological structure that connects the developing spinal cord to the gastrointestinal tract. These cysts are usually located along the spinal cord, particularly in the cervicothoracic region, and are filled with mucus-like fluid. While benign, neurenteric cysts can grow over time and cause compression of the spinal cord or nerve roots, leading to neurological symptoms in children. Because these cysts are extremely rare, early recognition and expert neurosurgical care are essential to prevent long-term complications. 🌍 Bangladesh Perspective In Bangladesh, neurenteric cysts in children are rarely diagnosed early due to the rarity of the condition, lack of awareness among general physicians, and limited access to MRI spine imaging in many districts. Children with subtle neurological signs such as limb weakness, spasticity, or walking difficulty are often misdiagnosed with cerebral palsy or orthopedic issues. Thanks to the availability of advanced pediatric neurosurgical services at the National Institute of Neurosciences & Hospital (NINS) and the Bangladesh Paediatric Neurocare Centre, Dr. Md. Nafaur Rahman is able to provide accurate diagnosis, microsurgical excision, and multidisciplinary follow-up for children with neurenteric cysts and other complex spinal anomalies. 🧬 Embryological Basis Neurenteric cysts arise from failed separation of the notochord and endoderm during early embryonic development. This leads to endodermal cell remnants being trapped in the spinal canal, which then form cysts. In some cases, these cysts may be associated with: Vertebral anomalies (e.g., hemivertebrae, butterfly vertebrae) Split cord malformation (diastematomyelia) Tethered spinal cord Other congenital spine defects 🧒 Clinical Features of Neurenteric Cyst in Children Most neurenteric cysts are located ventral to the spinal cord, especially in the cervicothoracic region, and symptoms may include: Neck stiffness or limited mobility Back pain Weakness or spasticity in the arms and legs Walking difficulties, frequent falls Loss of balance or coordination Sensory changes Bladder or bowel dysfunction in advanced cases Occasionally, cysts may enlarge rapidly and present with signs of acute spinal cord compression. 🔍 Diagnostic Evaluation 🧠 MRI Spine – Gold Standard Reveals size, location, internal signal, and compression of spinal cord Neurenteric cysts typically appear as well-defined, non-enhancing lesions ventral to the spinal cord 🦴 CT Scan Spine Helpful in identifying vertebral anomalies that may coexist 🧪 Neurological Examination Comprehensive pediatric neurological exam is essential for assessing motor, sensory, and reflex changes 🛠️ Surgical Management Surgery is the treatment of choice for symptomatic neurenteric cysts or those causing spinal cord compression. Dr. Md. Nafaur Rahman performs: ✂️ Microsurgical Excision Precise removal of the cyst while minimizing risk to the spinal cord Posterior approach is most commonly used Intraoperative neuromonitoring ensures safety during surgery Careful dissection is critical, especially for cysts adherent to the ventral cord 🔄 Postoperative Outcome With timely intervention: Most children experience marked neurological improvement Symptoms like pain, limb weakness, and walking difficulty often resolve Bladder and bowel function may improve if operated before permanent damage Recurrence is rare with complete excision but regular MRI follow-up is advised ⚠️ Risks of Delayed or No Treatment Without proper treatment, a growing neurenteric cyst can result in: Permanent paralysis or spastic paraparesis Loss of bladder and bowel control Deformity or scoliosis Spinal cord atrophy 👨‍⚕️ Why Dr. Md. Nafaur Rahman? Specialized in pediatric congenital spinal anomalies Expert in complex cyst excision with nerve-sparing techniques Operates with state-of-the-art neuromonitoring and imaging support Provides end-to-end care, including diagnosis, surgery, and rehabilitation Trusted nationwide for managing rare spinal conditions in children 📞 Get Expert Pediatric Neurosurgical Consultation Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, National Institute of Neurosciences & Hospital (NINS) Chief Consultant, Bangladesh Paediatric Neurocare Centre 📞 Serial/Appointment: 01912988182 | 01607033535 🌐 Website: www.neurosurgeonnafaur.com