Ratke's pocket cyst is a serious brain pathology. Its increase in size is accompanied by compression of the pituitary gland and optic nerves, which negatively affects the quality of human life. In this article, we will try to figure out what causes a cyst to occur, what to do when its first symptoms appear.
What is the function of a Ratke pocket?
This anatomical structure arises at the initial stages of embryo development in the womb. Subsequently, it is converted to the anterior pituitary gland of the brain. Normally, in a healthy newborn, Ratke’s pocket is absent. In some people, particles of this structure remain. They form an independent cavity. It is located in the immediate vicinity of the pituitary gland and serves as the basis for the initiation of cystic formation.
Features of the pathological process
Ratke's pocket cyst is a benign neoplasm. From the inside it is lined with a single-layer epithelium, and from the outside it is covered with a transparent capsule. The contents of the cyst is a liquid, usually yellow. Sometimes the secret has a grayish or bluish tint. By its consistency, it can be dense or gelatinous. Many compare the contents of the neoplasm with motor oil.
What factors provoke pathology?
The exact causes of the onset and development of the neoplasm have not been established. Doctors identify a number of factors, the presence of which increases the likelihood of a cyst. These include:
- hereditary predisposition;
- burdened viral diseases;
- inflammatory processes;
- hypoxia;
- intoxication of the pregnant woman;
- radiation, radiation;
- difficult childbirth;
- excessive exposure to UV rays.
A neoplasm is formed in the embryonic period. Doctors suggest that another structure arises from its remnants - the adenohypophysis. Ratke's pocket cysts and brain endocrine glands are of the same origin. Therefore, doctors tend to believe that a pathological neoplasm and pituitary adenoma can develop in parallel.
Who is at risk?
Congenital pathology described in the article is an infrequent phenomenon. It accounts for only 1% of cases among other neoplasms of a benign nature. Nevertheless, experts were able to identify a group of people whose representatives are more susceptible to the development of the disease. It includes:
- Mature women. The tendency to increase the size of the cyst and the appearance of its symptoms is observed after 40 years.
- Patients after meningitis or encephalitis of any etiology.
- Patients with a stroke.
- Workers of harmful chemical production.
- People whose relatives have been diagnosed with a brain tumor.
Coincidence on one or several items from the list above means an increased risk of developing a neoplasm. Such people should pay special attention to their own health, be sure to undergo an examination of the body.
The first manifestations of pathology
Ratke's pocket cyst is characterized by a prolonged asymptomatic course. Often patients do not suspect the presence of such an insidious pathology in the brain. Usually they learn about it after undergoing an MRI or other preventive examinations. The first symptoms of the neoplasm appear as its size increases. Ratke's pocket cyst begins to squeeze the optic nerve and the pituitary gland itself. As a result, pathological disorders in the blood supply to the brain develop, and the disorder in the work of its basic structures. In addition, the appearance of the following disorders is not excluded:
- Dizziness
- insomnia
- hallucinations;
- nausea and vomiting
- tinnitus;
- short-term memory lapses;
- impaired coordination of movements.
In 80% of patients, pathology is accompanied by diseases of the endocrine system. Also, many note the appearance of mental disorders, confusion. The degree of manifestation of clinical symptoms largely depends on the size of the neoplasm, the pressure on the adjacent nerve endings and blood vessels.
Probable complications
What are the consequences of a Ratke pocket cyst? It is not the neoplasm itself that is dangerous, but the rate of its growth. Therefore, after identifying the pathology, the patient is still under the supervision of a doctor for some time. With its intensive growth, an urgent operation is indicated. Lack of adequate therapy can lead to unpleasant consequences. First, the patient loses his sight. Then the clinical picture is supplemented by mental disorders and destruction of the pituitary gland. In especially serious cases, cyst degenerates into a malignant tumor.
Diagnostic Methods
If a Ratka pocket cyst is suspected, the patient must first visit an endocrinologist. Sometimes an additional consultation with a neurologist is required. To confirm the diagnosis and determine the size of the neoplasm, the following diagnostic methods are used:
- MRI This research method is considered the most informative. From the pictures, the doctor can assess the size, location and anatomical characteristics of the cyst. All data is necessary for subsequent treatment.
- CT Performing computed tomography can recognize calcification. The presence of this process usually indicates an alternative diagnosis - craniopharyngioma.
- Angiographic study of blood vessels of the brain.
To exclude the malignant nature of the neoplasm, an additional examination by an oncologist may be required. Usually it involves taking a puncture for subsequent study of the material in the laboratory.
Conservative therapy
The treatment regimen for the pathology is determined by the doctor. In many ways, it depends on the accompanying clinical picture, the patient’s health status and the size of the cyst. With an asymptomatic course of the pathological process, wait-and-see tactics are chosen. The doctor monitors the well-being of the patient, assesses the MRI of the brain in dynamics. If the formation is small, latent symptoms are present, hormone therapy is prescribed. Drugs are selected individually.
Surgical intervention
A completely different approach requires an increasing in size cyst of Ratke's pocket. Treatment in this case also begins with hormonal agents. If therapy is ineffective, the patient becomes worse, surgery is prescribed. Today, in practice, two types of surgical interventions are used, each of which has its own characteristics.
- Classical transfenoidal operation. It reduces to the removal of a cyst through an incision in the nasal concha. Access to Ratke’s pocket is possible only through the sphenoid sinus. To see the surgical field well, the surgeon uses a binocular microscope.
- The most popular is nevertheless laparoscopic intervention. It is carried out using a special device - an endoscope. During the operation, the surgeon can easily remove the neoplasm without damaging the vessels and nerve endings near the pituitary gland. The doctor also enters the cranium through the nasal passages.
After removal of the cyst, all its contents must be sent to the laboratory. Histological examination of the secret eliminates the malignant nature of the pathology. The surgical options described just above are the only effective methods of dealing with such a problem as a Ratke pocket cyst. Treatment with folk remedies is strictly contraindicated.
Prognosis for recovery
Timely detection of cysts is the key to a quick recovery of the body. Endocrinopathy or vision problems at some point may become irreversible. The main thing is not to ignore the doctor’s recommendations for treatment. Most often, patients with such a diagnosis are prescribed an operation during which a Ratke pocket cyst is completely excised. Consequences of a negative nature in this case can be minimized. The relapse rate after surgery is less than 5%.