Rathke Cleft Cyst

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Symptoms of a Rathke Cleft Cyst

A very small percentage of Rathke cleft cysts cause symptoms. Problems may occur when the cyst grows larger from the continual accumulation of fluid and presses on the nerves and structures around it.

Vision changes: When a Rathke cleft cyst fills with fluid and expands upward, it can compress the optic chiasm, the space in front of the pituitary gland where the left and right optic nerves cross, and lead to vision changes, such as loss of peripheral vision.

  • Impingement of the optic chiasm can cause partial blindness in the outer half of both eyes’ visual fields. Problems with an individual’s peripheral vision, also known as bitemporal hemianopsia, limits sight to what is only directly ahead. Many people with Rathke cleft cysts do not become aware of their visual loss until it is quite severe.
  • Other related symptoms include blurry vision and colors seeming less bright, frequent headaches, nausea, fatigue, and confusion.

Pituitary failure or hypopituitarism: Rathke cleft cysts may also compress the pituitary gland— the master gland itself— which releases hormones that affect growth and physical development, the immune system, and the breast’s production of milk. The pituitary gland also controls other hormone-releasing glands in your body, including the thyroid, adrenals, ovaries, and testicles. Related symptoms include:

  • Low blood pressure
  • Digestive issues/constipation
  • Decreased or absent libido
  • Extremely dry skin
  • Difficulty with regulation of body temperature

Compression of the pituitary stalk, the connection between the brain and the gland, is thought to be the cause of elevated prolactin levels, and can cause premenopausal women to have irregular or absent menstruation, as well as causing milk production from the breasts that is not related to childbirth or nursing.

In the extremely rare case that a Rathke cleft cyst is present in a child, that child may experience late puberty or lack of growth.

More severe hypopituitarism can lead to dangerously low cortisol levels, which can include the following symptoms:

  • Loss of appetite
  • Decreased energy/fatigue
  • Decreased mental function
  • Dizziness
  • Headaches
  • Confusion

If the liquid accumulation is especially rapid, a patient can develop headaches, or experience a worsening of headaches. Rarely, a Rathke cleft cyst may bleed, causing apoplexy or rupture, which can cause aseptic meningitis.

Reviewed by Georgiana Dobri, MD
Last reviewed/last updated: September 2017