Tarlov cyst

Tarlov cysts, also known as perineural cysts, are fluid-filled protrusions of the nerve root sheaths that usually occur in the area of the sacral spine. They are asymptomatic in many cases, but can also cause pain in the back, buttocks and legs, as well as neurological deficits. The exact cause of their development is not fully understood. Treatment varies from conservative measures such as pain medication and physiotherapy to surgical intervention for severe symptoms.

Tarlov cysts most commonly occur in the sacral area and typically affect the sacral nerve roots S2 or S3  *. In principle, however, they can occur anywhere along the spine. *, *

They develop when fluid leaks into the space between the perineurium (which surrounds individual nerve fiber bundles) and the epineurium (which surrounds the entire nerve) *. Usually there is a small connection to the cerebral spinal fluid space, which can cause nerve roots to be compressed *, *. In contrast to other meningeal cysts, Tarlov cysts take longer to fill with contrast agent during myelography, an imaging technique used to visualize the cerebrospinal fluid space, and do not collapse immediately during CSF drainage. *, *, *

References

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