Cases reported "Tarlov Cysts"

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1/12. Surgical treatment of sacral perineural cysts. A case report.

    Most of the perineural cysts (Tarlov's cysts) are asymptomatic. They are usually diagnosed incidentally, and a specific treatment is not necessary. They should be operated on, only if they produce progressive or disabling symptoms and/or sign clearly attributable to them. Several reports have been made regarding their sign and symptom, neurological and radiological features. This is a report emphasizing on their surgical indication and surgical treatment. We reported a 48 year-old woman who underwent surgery because of the symptomatic perineural cyst. It is concluded that the total excision of the perineural cyst is not necessary and a partial resection with a resultant reduction in the cyst size results in a favourable outcome. ( info)

2/12. Tarlov cyst as a rare cause of S1 radiculopathy: A case report.

    A 37-year-old female physician presented with a chief complaint of left posterior thigh pain, which began insidiously approximately 4 months before her initial examination. Initially, she had been evaluated by her physician, and magnetic resonance imaging (MRI) was ordered. The MRI scan was reported to be within normal limits, with the exception of minimal disc bulging at L4-5. She had received physical therapy with little benefit and was referred for physiatric assessment. review of the patient's original MRI scan showed the presence of perineurial (Tarlov) cysts within the sacral canal at the level of S2, with compression of the adjacent nerve root. Subsequent electrodiagnostic testing showed axonal degeneration consistent with an S1 radiculopathy. tarlov cysts can be a rare cause of lumbosacral radiculopathy and should be considered in the differential diagnosis of radicular leg pain. ( info)

3/12. tarlov cysts: a study of 10 cases with review of the literature.

    OBJECT: Tarlov or perineurial cysts are lesions of the nerve root most often found in the sacral region. Although there is agreement that asymptomatic Tarlov cysts should be followed, it is still debated whether patients with symptomatic tarlov cysts should be treated surgically. The authors assessed the outcome and efficacy of cyst wall resection in 10 patients with symptomatic tarlov cysts. The medical literature is reviewed, theories of origin are evaluated, and suggestions as to their cause and pathogenesis are offered. methods: Ten consecutive patients harboring symptomatic tarlov cysts were treated by the senior author between 1989 and 1999. All patients were assessed for neurological deficits and pain by neurological examination and visual analog scale, respectively. Computerized tomography myelography was performed in all patients to diagnose delayed filling of the cysts. A sacral laminectomy with resection of the sacral cyst or cysts was performed in all patients. Resected material from eight of 10 patients was submitted for histopathological evaluation. Seven (70%) of 10 patients obtained complete or substantial resolution of their symptoms, with an average follow up of 31.7 months. All of these patients had tarlov cysts larger than 1.5 cm in diameter, producing radicular pain or bladder and bowel dysfunction. Three (30%) of 10 patients experienced no significant improvement. All three patients harbored tarlov cysts smaller than 1.5 cm in diameter, producing nonradicular pain. Histopathological examination was performed on specimens from eight of 10 patients, which demonstrated nerve fibers in 75% of cases, ganglion cells in 25% of cases, and evidence of old hemorrhage in half. CONCLUSIONS: Large cysts (> 1.5 cm) and the presence of associated radicular symptoms strongly correlate with excellent outcome. tarlov cysts may result from increased hydrostatic pressure and trauma. ( info)

4/12. Filling of a sacral bone defect from a perineurial cyst by cementation.

    In this study we present a case of Tarlov's cyst that is treated operatively. The operation involved partial excision and oversewing of the cyst wall with connection to the dural sac and methylmethacrylate filling of the sacral bone defect that is formed by the cyst to prevent cyst recurrence. In symptomatic cases Tarlov's cyst can be treated operatively with a favorable outcome. ( info)

5/12. Combination of lumbar kyphosis, epidural lipomatosis, and perineural cyst as a cause of neurological deficit: a case report.

    We describe the rare simultaneous occurrence of epidural lipomatosis and a perineural cyst at the same level, lumbar kyphosis, osteoporotic vertebral fractures, and neurological deficits. A 75-year-old corticosteroid-dependent female farmer presented with severe low back pain, progressive lumbar kyphosis, and inability to stand because of numbness and muscle weakness of both legs. Plain radiographs displayed markedly decreased bone density, significant lumbar kyphosis, and vertebral compression fractures of L2, L3, and L4. magnetic resonance imaging of the lumbar spine revealed a perineural cyst at the L2-3 level, extensive epidural lipomatosis, and spinal canal stenosis. laminectomy from L3 to L5 with resection of epidural fatty tissue restored her walking ability. We postulate that the osteoporotic fractures and epidural lipomatosis were induced by corticosteroid therapy. Preexisting degenerative lumbar kyphosis of the type commonly seen in elderly farmers could have promoted osteoporotic lumbar vertebral fractures at points where bending stress had been strongly exerted. The combination of a perineural cyst and epidural lipomatosis at the same level has not been reported previously. ( info)

6/12. abdominal pain secondary to a sacral perineural cyst.

    BACKGROUND CONTEXT: Perineural cysts are commonly found in the sacral region and are incidently discovered on imaging studies performed for the evaluation of low back and/or leg pain. PURPOSE: To report on a patient presenting with abdominal pain secondary to a large sacral perineural cyst. STUDY DESIGN/SETTING: Case report. methods/PATIENT SAMPLE: A 47-year-old woman was referred to a specialized multidisciplinary spine center with complaints of left lower quadrant abdominal pain and left leg pain. Of significant note was the presence of constipation and urinary frequency over the preceding 8 months. physical examination was normal. magnetic resonance imaging of the lumbosacral spine revealed large perineural cysts eroding the sacrum and extending to the pelvis. The presence of abdominal symptoms prompted a neurosurgical consultation. However, after considering the possible risks associated with the surgical procedure, the patient opted to follow the nonsurgical route. RESULT AND CONCLUSIONS: Although commonly visualized, sacral perineural cysts are rarely symptomatic. When symptomatic, it may be secondary to its size and location. Presence of abdominal pain in a patient with back and/or leg pain should prompt the evaluation of the lumbosacral spine. ( info)

7/12. CT-guided percutaneous aspiration of Tarlov cyst as a useful diagnostic procedure prior to operative intervention.

    Tarlov or perineural cysts are lesions of the nerve root most often found in the sacral region. Several authors recommend surgical treatment of symptomatic tarlov cysts. However, successful surgical treatment is dependent on appropriate patient selection.In this article, we report three cases of a sacral perineural cyst, causing sciatic pain, and emphasize the usefulness of CT-guided percutaneous aspiration as an important diagnostic and prognostic procedure prior to definitive operative treatment. ( info)

8/12. diagnosis and management of sacral tarlov cysts. Case report and review of the literature.

    Perineurial (Tarlov) cysts are meningeal dilations of the posterior spinal nerve root sheath that most often affect sacral roots and can cause a progressive painful radiculopathy. tarlov cysts are most commonly diagnosed by lumbosacral magnetic resonance imaging and can often be demonstrated by computerized tomography myelography to communicate with the spinal subarachnoid space. The cyst can enlarge via a net inflow of cerebrospinal fluid, eventually causing symptoms by distorting, compressing, or stretching adjacent nerve roots. It is generally agreed that asymptomatic tarlov cysts do not require treatment. When symptomatic, the potential surgery-related benefit and the specific surgical intervention remain controversial. The authors describe the clinical presentation, treatment, and results of surgical cyst fenestration, partial cyst wall resection, and myofascial flap repair and closure in a case of a symptomatic sacral Tarlov cyst. They review the medical literature, describe various theories on the origin and pathogenesis of tarlov cysts, and assess alternative treatment strategies. ( info)

9/12. diagnosis-related pitfall of a lateral sacral cyst. Case report.

    Because physical examination typically demonstrates normal findings in cases of low-back pain, diaglosis of the cause can be challenging. Frequent magnetic resonance imaging studies of the lumbosacral spine can typically lead to discovery of benign diseases and thus misinterpretation of these images. The authors report an unusual case in which a functional ovarian cyst was incidentally associated with a perineural cyst and mimicked a lateral sacral meningocele. In light of this, the authors recommend repeated examinations to avoid mistakes. ( info)

10/12. Use of percutaneous endoscopy to place syringopleural or cystoperitoneal cerebrospinal fluid shunts: technical note.

    The authors describe a technique for percutaneous endoscopic shunt placement to treat clinically symptomatic spinal cysts. Seven patients underwent the procedure--five with syringomyelia, one with a symptomatic perineurial cyst, and one with a large arachnoid cyst. In all patients the shunt was successfully placed, and clinical improvement occurred in six. In four patients the entire procedure was performed endoscopically, whereas in three conversion to an open surgical exposure was required for safe access of a syrinx cavity. overall, however, the pleural or peritoneal catheter was successfully placed endoscopically in all seven patients. There were two cases of postoperative positional headaches of which one required valve revision. In one case the catheter migrated and required repositioning. Percutaneous endoscopic shunt placement appears feasible in appropriately selected patients. ( info)
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