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Blake Pouch Cyst
Anne M. Kennedy, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Blake pouch cyst (BPC)
            • Synonyms

              • Persistent Blake pouch (BP)
            • Definitions

              • Persistent cystic evagination of the area membranacea under inferior vermis in cerebellar vallecula
              • Diagnostic criteria
                • Normal vermian size, anatomy in midline sagittal view
                • < 30° anticlockwise rotation of vermis
                • Normal size of cisterna magna
                • Cisterna magna septa may be bowed laterally
                • 4th ventricle choroid plexus at superior margin of BPC

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                • Image Interpretation Pearls

                                  • Reporting Tips

                                    Selected References

                                    1. Azab WA et al: Blake's pouch cyst. Surg Neurol Int. 5:112, 2014
                                    2. Contro E et al: Open fourth ventricle prior to 20 weeks' gestation: a benign finding? Ultrasound Obstet Gynecol. 43(2):154-8, 2014
                                    3. Robinson AJ: Inferior vermian hypoplasia--preconception, misconception. Ultrasound Obstet Gynecol. 43(2):123-36, 2014
                                    4. Gandolfi Colleoni G et al: Prenatal diagnosis and outcome of fetal posterior fossa fluid collections. Ultrasound Obstet Gynecol. 39(6):625-31, 2012
                                    5. Paladini D et al: Abnormal or delayed development of the posterior membranous area of the brain: anatomy, ultrasound diagnosis, natural history and outcome of Blake's pouch cyst in the fetus. Ultrasound Obstet Gynecol. 39(3):279-87, 2012
                                    6. Volpe P et al: Brainstem-vermis and brainstem-tentorium angles allow accurate categorization of fetal upward rotation of cerebellar vermis. Ultrasound Obstet Gynecol. 39(6):632-5, 2012
                                    7. Bertucci E et al: Vermian biometric parameters in the normal and abnormal fetal posterior fossa: three-dimensional sonographic study. J Ultrasound Med. 30(10):1403-10, 2011
                                    8. Kapur RP et al: Normal and abnormal anatomy of the cerebellar vermis in midgestational human fetuses. Birth Defects Res A Clin Mol Teratol. 85(8):700-9, 2009
                                    9. Malinger G et al: The fetal cerebellum. Pitfalls in diagnosis and management. Prenat Diagn. 29(4):372-80, 2009
                                    10. Robinson AJ et al: The cisterna magna septa: vestigial remnants of Blake's pouch and a potential new marker for normal development of the rhombencephalon. J Ultrasound Med. 26(1):83-95, 2007
                                    11. Robinson AJ et al: The fetal cerebellar vermis: assessment for abnormal development by ultrasonography and magnetic resonance imaging. Ultrasound Q. 23(3):211-23, 2007
                                    12. Utsunomiya H et al: Midline cystic malformations of the brain: imaging diagnosis and classification based on embryologic analysis. Radiat Med. 24(6):471-81, 2006
                                    13. Zalel Y et al: Rotation of the vermis as a cause of enlarged cisterna magna on prenatal imaging. Ultrasound Obstet Gynecol. 27(5):490-3, 2006
                                    14. Nelson MD Jr et al: A different approach to cysts of the posterior fossa. Pediatr Radiol. 34(9):720-32, 2004
                                    15. Malinger G et al: The fetal cerebellar vermis: normal development as shown by transvaginal ultrasound. Prenat Diagn. 21(8):687-92, 2001
                                    16. Calabrò F et al: Blake's pouch cyst: an entity within the Dandy-Walker continuum. Neuroradiology. 42(4):290-5, 2000
                                    17. Tortori-Donati P et al: Cystic malformations of the posterior cranial fossa originating from a defect of the posterior membranous area. Mega cisterna magna and persisting Blake's pouch: two separate entities. Childs Nerv Syst. 12(6):303-8, 1996
                                    18. Kollias SS et al: Cystic malformations of the posterior fossa: differential diagnosis clarified through embryologic analysis. Radiographics. 13(6):1211-31, 1993
                                    19. Strand RD et al: Cystic retrocerebellar malformations: unification of the Dandy-Walker complex and the Blake's pouch cyst. Pediatr Radiol. 23(4):258-60, 1993
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Clinical Issues

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Blake pouch cyst (BPC)
                                              • Synonyms

                                                • Persistent Blake pouch (BP)
                                              • Definitions

                                                • Persistent cystic evagination of the area membranacea under inferior vermis in cerebellar vallecula
                                                • Diagnostic criteria
                                                  • Normal vermian size, anatomy in midline sagittal view
                                                  • < 30° anticlockwise rotation of vermis
                                                  • Normal size of cisterna magna
                                                  • Cisterna magna septa may be bowed laterally
                                                  • 4th ventricle choroid plexus at superior margin of BPC

                                              IMAGING

                                              • General Features

                                                • Ultrasonographic Findings

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Natural History & Prognosis

                                                                DIAGNOSTIC CHECKLIST

                                                                • Consider

                                                                  • Image Interpretation Pearls

                                                                    • Reporting Tips

                                                                      Selected References

                                                                      1. Azab WA et al: Blake's pouch cyst. Surg Neurol Int. 5:112, 2014
                                                                      2. Contro E et al: Open fourth ventricle prior to 20 weeks' gestation: a benign finding? Ultrasound Obstet Gynecol. 43(2):154-8, 2014
                                                                      3. Robinson AJ: Inferior vermian hypoplasia--preconception, misconception. Ultrasound Obstet Gynecol. 43(2):123-36, 2014
                                                                      4. Gandolfi Colleoni G et al: Prenatal diagnosis and outcome of fetal posterior fossa fluid collections. Ultrasound Obstet Gynecol. 39(6):625-31, 2012
                                                                      5. Paladini D et al: Abnormal or delayed development of the posterior membranous area of the brain: anatomy, ultrasound diagnosis, natural history and outcome of Blake's pouch cyst in the fetus. Ultrasound Obstet Gynecol. 39(3):279-87, 2012
                                                                      6. Volpe P et al: Brainstem-vermis and brainstem-tentorium angles allow accurate categorization of fetal upward rotation of cerebellar vermis. Ultrasound Obstet Gynecol. 39(6):632-5, 2012
                                                                      7. Bertucci E et al: Vermian biometric parameters in the normal and abnormal fetal posterior fossa: three-dimensional sonographic study. J Ultrasound Med. 30(10):1403-10, 2011
                                                                      8. Kapur RP et al: Normal and abnormal anatomy of the cerebellar vermis in midgestational human fetuses. Birth Defects Res A Clin Mol Teratol. 85(8):700-9, 2009
                                                                      9. Malinger G et al: The fetal cerebellum. Pitfalls in diagnosis and management. Prenat Diagn. 29(4):372-80, 2009
                                                                      10. Robinson AJ et al: The cisterna magna septa: vestigial remnants of Blake's pouch and a potential new marker for normal development of the rhombencephalon. J Ultrasound Med. 26(1):83-95, 2007
                                                                      11. Robinson AJ et al: The fetal cerebellar vermis: assessment for abnormal development by ultrasonography and magnetic resonance imaging. Ultrasound Q. 23(3):211-23, 2007
                                                                      12. Utsunomiya H et al: Midline cystic malformations of the brain: imaging diagnosis and classification based on embryologic analysis. Radiat Med. 24(6):471-81, 2006
                                                                      13. Zalel Y et al: Rotation of the vermis as a cause of enlarged cisterna magna on prenatal imaging. Ultrasound Obstet Gynecol. 27(5):490-3, 2006
                                                                      14. Nelson MD Jr et al: A different approach to cysts of the posterior fossa. Pediatr Radiol. 34(9):720-32, 2004
                                                                      15. Malinger G et al: The fetal cerebellar vermis: normal development as shown by transvaginal ultrasound. Prenat Diagn. 21(8):687-92, 2001
                                                                      16. Calabrò F et al: Blake's pouch cyst: an entity within the Dandy-Walker continuum. Neuroradiology. 42(4):290-5, 2000
                                                                      17. Tortori-Donati P et al: Cystic malformations of the posterior cranial fossa originating from a defect of the posterior membranous area. Mega cisterna magna and persisting Blake's pouch: two separate entities. Childs Nerv Syst. 12(6):303-8, 1996
                                                                      18. Kollias SS et al: Cystic malformations of the posterior fossa: differential diagnosis clarified through embryologic analysis. Radiographics. 13(6):1211-31, 1993
                                                                      19. Strand RD et al: Cystic retrocerebellar malformations: unification of the Dandy-Walker complex and the Blake's pouch cyst. Pediatr Radiol. 23(4):258-60, 1993