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[Sacral perineural cyst--report of a case]
1Department of Neurosurgery, Asahikawa Red Cross Hospital, Japan.
No Shinkei Geka. Neurological Surgery
|June 1, 1988
Summary
Sacral perineural cysts, fluid-filled sacs on sacral nerve roots, can cause pain and neurological issues. Advanced imaging like MRI aids in diagnosing these often-overlooked spinal conditions.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Sacral cysts, including sacral perineural cysts, are documented in medical literature.
- First described by Tarlov in 1938, sacral perineural cysts are extradural cysts affecting sacral or coccygeal nerve roots.
Observation:
- While often asymptomatic, sacral perineural cysts can mimic lumbar disc herniation symptoms.
- These include low back pain, sciatic pain, sensory/motor deficits, and urinary dysfunction due to nerve root impingement.
Findings:
- Cysts are thin-walled and fluid-filled, located between the endoneurium and perineurium.
- Microscopically, cyst walls contain peripheral nerve fibers or ganglionic cells with meningeal epithelium.
- Myelography and CT myelography can show cyst filling with contrast media, while MRI offers improved visualization.
Implications:
- Sacral perineural cysts can cause significant sacral bone erosion.
- Accurate diagnosis and understanding of their origin are crucial for effective management.
- Further research is needed to fully elucidate the pathogenesis and optimal treatment strategies.