Ratchet's cyst pocket: the causes of appearance and treatment

The cyst of Ratchet pocket is a serious pathology of the brain. An increase in her size is accompanied by compression of the pituitary gland and optic nerves, which negatively affects the quality of life of a person. In this article we will try to understand what causes lead to the onset of the cyst, what to do when the first symptoms appear.

What is the function of the pocket of Ratke?

This anatomical structure arises at the initial stages of embryo development in the womb. Subsequently, it is transformed into anterior portion of the pituitary gland of the brain. Ratke does not have a pocket for a healthy newborn. Some people have particles of this structure. They form an independent cavity. It is located in the immediate vicinity of the pituitary gland and forms the basis for the onset of cystic formation.

Features of the pathological process

The cyst of Ratchet pocket is a benign neoplasm. From the inside it is lined with a single-layered epithelium, and on 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 tinge. By its consistency, it can be dense or gelatinous. Many compare the contents of the growth with engine oil.

What factors provoke pathology?

The exact causes of the onset and development of neoplasm have not been established. Doctors identify a number of factors, the presence of which increases the likelihood of the appearance of a cyst. These include:

• Hereditary predisposition;
• Viral diseases with a burdensome course;
• Inflammatory processes;
• Hypoxia;
• Intoxication of the body of a pregnant woman;
• Radiation, radiation;
• Complex delivery;
• Excessive exposure to UV rays.

Neoplasm is formed in the embryonic period. Doctors suppose that from its remnants another structure, adenohypophysis, is born. The cyst of Ratchet pocket and the gland of internal secretion of the brain have the same origin. Therefore, doctors tend to believe that the pathological neoplasm and adenoma of the pituitary gland can develop in parallel.

Who is at high risk?

The congenital pathology described in the article is a rare phenomenon. It accounts for only 1% of cases among other neoplasms of a benign nature. Still, specialists were able to identify a group of people whose representatives are more susceptible to the development of ailment. It includes:

1. Women of mature age. The tendency to increase the size of the cyst and the appearance of its symptoms is observed after 40 years.
2. Patients after meningitis or encephalitis of any etiology.
3. Patients who suffered a stroke.
4. Workers of harmful chemical production.
5. People whose relatives had a brain tumor diagnosed.

Coincidence on one or more of the items listed 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

The cyst of Ratke's pocket is characterized by a long asymptomatic course. Often, patients are unaware of the existence of such an insidious pathology in the brain. Usually they learn about it after passing MRI or other preventive examinations. The first symptoms of neoplasm appear as the size of the tumor grows. The cyst of the pocket Ratke begins to squeeze the optic nerve and the pituitary gland itself. As a result, pathological disturbances develop in the blood supply to the brain, discord in the work of its basic structures. In addition, the appearance of the following disorders is not excluded:

• Dizziness;
• Insomnia;
• Hallucinations;
• Nausea and vomiting;
• Noise in the ears;
• Short-term dips in memory;
• Violations of coordination of movements.

In 80% of patients, pathology is accompanied by diseases of the endocrine system. Many also 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 neighboring nerve endings and blood vessels.

Possible complications

What are the consequences of the cyst of Ratka pocket? It is not the new growth that is dangerous, but the speed of its growth. Therefore, after revealing the pathology, the patient is still under medical supervision for some time. With its intensive growth, an urgent operation is indicated. The lack of adequate therapy can lead to unpleasant consequences. First, the patient loses sight. Then the clinical picture is supplemented by mental disorders and destruction of the pituitary gland. In particularly serious cases, a cyst degenerates into a malignant tumor.

Methods of diagnosis

If you suspect a cyst of Ratka's pocket, the patient should first of all visit the endocrinologist. Sometimes you need additional advice from a neurologist. To confirm the diagnosis and determine the size of the tumor, the following diagnostic methods are used:

1. MRI. This method of research is considered the most informative. According to the pictures, the doctor can estimate the size, location and anatomical characteristics of the cyst. All data are necessary for subsequent treatment.
2. CT. Carrying out of a computer tomography allows to recognize calcification. The presence of this process usually indicates an alternative diagnosis - craniopharyngioma.
3. Angiographic study of cerebral vessels.

To exclude malignant neoplasm, an additional examination with an oncologist may be required. Usually it involves taking a puncture for later study of the material in the laboratory.

Conservative therapy

The treatment of pathology is determined by the doctor. In many ways, it depends on the concomitant clinical picture, the patient's health status and the size of the cyst. In the asymptomatic course of the pathological process, wait-and-see tactics are chosen. The doctor monitors the state of health of the patient, evaluates the MRI of the brain in dynamics. If the size of the formation is small, latent symptoms are present, hormonal therapy is prescribed. Preparations are selected individually.

Surgical intervention

A completely different approach requires the increasing size of the cyst of Ratka's pocket. Treatment in this case also begins with hormonal means. If therapy is ineffective, the patient becomes worse, an operation is prescribed. Today, in practice, two types of surgical interventions are used, each of which has its own peculiarities.

• Classical transphenoidal operation. It is reduced to the removal of the cyst through the incision in the nasal concha. Access to Rathke's pocket is possible only through the sphenoid sinus. To see the operating field clearly, the surgeon applies a binocular microscope.
• The most popular is still laparoscopic intervention. It is carried out with the help of a special device - an endoscope. During surgery, the surgeon can easily remove the tumor without damaging the vessels and nerve endings near the pituitary gland. In the skull, the doctor also penetrates through the nasal passages.

After removing the cyst, all of its contents must be sent to the laboratory. Histological examination of secretion allows to exclude malignant nature of pathology. The above described options for surgical intervention are the only effective methods to deal with such a problem as the cyst of Ratche's pocket. Treatment with folk remedies is categorically contraindicated.

Prognosis for recovery

Timely detection of the cyst is the key to rapid 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 this diagnosis are assigned an operation, during which the cyst of Ratka's pocket is completely excised. The consequences of a negative nature in this case can be reduced to a minimum. The relapse rate after the surgery is less than 5%.