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    Mega Cisterna Magna

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    Fierda Putri Pratiwi
    Mega cisterna magna refers to an enlarged subarachnoid space in the posterior cranial fossa that is typically seen in about 1% of brains imaged postnatally. It is usually an incidental asymptomatic finding over 10mm on imaging. While it has been associated with conditions like infarction or chromosomal abnormalities, an isolated mega cisterna magna with normal ventricles carries a good prognosis.

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    Mega Cisterna Magna

    Uploaded by

    Fierda Putri Pratiwi
    125 views2 pages
    Mega cisterna magna refers to an enlarged subarachnoid space in the posterior cranial fossa that is typically seen in about 1% of brains imaged postnatally. It is usually an incidental asymptomatic finding over 10mm on imaging. While it has been associated with conditions like infarction or chromosomal abnormalities, an isolated mega cisterna magna with normal ventricles carries a good prognosis.

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    Mega cisterna magna

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    Mega cisterna magna refers to an enlarged subarachnoid space in the posterior cranial fossa that is typically seen in about 1% of brains imaged postnatally. It is usually an incidental asymptomatic finding over 10mm on imaging. While it has been associated with conditions like infarction or chromosomal abnormalities, an isolated mega cisterna magna with normal ventricles carries a good prognosis.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    125 views2 pages

    Mega Cisterna Magna

    Uploaded by

    Fierda Putri Pratiwi
    Mega cisterna magna refers to an enlarged subarachnoid space in the posterior cranial fossa that is typically seen in about 1% of brains imaged postnatally. It is usually an incidental asymptomatic finding over 10mm on imaging. While it has been associated with conditions like infarction or chromosomal abnormalities, an isolated mega cisterna magna with normal ventricles carries a good prognosis.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Mega cisterna magna 

    refers to a normal variant characterised by a truly focal enlargement


    of the CSF-filled subarachnoid space in the inferior and posterior portions of the posterior cranial
    fossa. It is an incidental finding on neuroimaging, and no imaging follow up is necessary. 

    Epidemiology
    A mega cisterna magna is thought to occur in ~1% of all brains imaged postnatally. 

    Associations
    Especially if noted antenatally, a mega cisterna magna has been associated with:

     infarction
     inflammation/infection: particularly cytomegalovirus
     chromosomal abnormalities: especially trisomy 18

    However, when a mega cisterna magna occurs as an isolated finding with normal ventricles the
    prognosis is good.

    Clinical presentation
    There are no specific symptoms related to this condition. 

    Pathology
    Some authors have proposed that mega cisterna magna is a result of a delayed Blake pouch
    fenestration; when fenestration does not occur, it results in a Blake pouch cyst 6. 

    Radiographic features
    Ultrasound
    In antenates, mega cisterna magna refers to an enlarged retrocerebellar CSF space:

     usually >10 mm in antenatal imaging (some consider up to 12 mm within normal limits)


     septa may be seen within a mega cisterna magna, which are thought to be Blake pouch
    vestigial remnants 3
     vermis should be closely evaluated to exclude Dandy-Walker continuum abnormalities

    CT/MRI

    i
    Typically seen as prominent retrocerebellar cerebrospinal fluid (CSF) appearing space with a
    normal vermis, normal 4th ventricle, and normal cerebellar hemispheres. An enlarged cisterna
    magna usually measures >10 mm on midsagittal images. An enlarged posterior fossa can
    sometimes be present 6. 

    History and etymology


    The term was first coined by Gonsette et al in 1962, in patients with cerebellar atrophy. 

    Differential diagnosis
    Mega cisterna magna needs to be distinguished from other causes of an enlarged retrocerebellar
    CSF space:

     arachnoid cyst
     epidermoid cyst: often shows a heterogeneous/dirty signal on FLAIR and restricted
    diffusion
     cerebellar atrophy / cerebellar hypoplasia
     Dandy-Walker malformation: vermis not intact
     Blake pouch cyst: usually a hydrocephalus is present 
     pilocytic astrocytoma: if very posterior and predominantly cystic

    ii

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