Global InformationTarlov cyst information
| Tarlov cyst | |
|---|---|
| Other names | Perineural cysts[1] |
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| MRI image showing a Tarlov cyst | |
| Specialty | Oncology, neurology, radiology  |
Tarlov cysts, are type II innervated meningeal cysts, cerebrospinal-fluid-filled (CSF) sacs most frequently located in the spinal canal of the sacral region of the spinal cord (S1–S5) and much less often in the cervical, thoracic or lumbar spine. They can be distinguished from other meningeal cysts by their nerve-fiber-filled walls. Tarlov cysts are defined as cysts formed within the nerve-root sheath at the dorsal root ganglion.[2] The etiology of these cysts is not well understood; some current theories explaining this phenomenon have not yet been tested or challenged but include increased pressure in CSF, filling of congenital cysts with one-way valves, inflammation in response to trauma and disease. They are named for American neurosurgeon Isadore Tarlov, who described them in 1938.[3]
Tarlov cysts are relatively uncommon when compared to other neurological cysts. Initially, Isadore Tarlov believed them to be asymptomatic, however as his research progressed, Tarlov found them to be symptomatic in a number of patients. These cysts are often detected incidentally during MRI or CT scans for other medical conditions. They are also observed using magnetic resonance neurography with communicating subarachnoid cysts of the spinal meninges. Cysts with diameters of 1 cm or larger are more likely to be symptomatic; although cysts of any size may be symptomatic dependent on location and etiology. Some 40% of patients with symptomatic Tarlov cysts can associate a history of trauma or childbirth.[4] Current treatment options include CSF aspiration, fibrin-glue therapy, laminectomy with wrapping of the cyst, among other surgical treatment approaches. Interventional treatment of Tarlov cysts is the only means by which symptoms might permanently be resolved due to the fact that the cysts often refill after aspiration. Tarlov cysts often enlarge over time, especially if the sac has a check valve type opening. They are differentiated from other meningeal and arachnoid cysts because they are innervated and diagnosis can in cases be demonstrated with subarachnoid communication.
Tarlov perineural cysts have occasionally been observed in patients with Marfan syndrome, Ehlers–Danlos syndrome, and Loeys–Dietz syndrome.[5]
- ^ Ju CI, Shin H, Kim SW, Kim HS (March 2009). "Sacral perineural cyst accompanying disc herniation". J Korean Neurosurg Soc. 45 (3): 185–7. doi:10.3340/jkns.2009.45.3.185. PMC 2666123. PMID 19352483.
- ^ Goyal RN, Russell NA, Benoit BG, Belanger JM (1987). "Intraspinal cysts: a classification and literature review". Spine. 12 (3): 209–213. doi:10.1097/00007632-198704000-00003. PMID 3589815. S2CID 13083611.
- ^ Kumar Singh Pankaj; Kumar Singh Vinay; Azam Amir; Gupta Sanjeev (2009). "Tarlov Cyst and Infertility". J Spinal Cord Med. 32 (2): 191–197. doi:10.1080/10790268.2009.11760771. PMC 2678291. PMID 19569467.
- ^ Nishiura I, Koyama T, Handa J (1985). "Intrasacral perineural cyst". Surg Neurol. 23 (3): 265–269. doi:10.1016/0090-3019(85)90093-x. PMID 3975809.
- ^ Oaklander AL, Long DM, Larvie M, Davidson CJ (February 28, 2013). "Case 7-2013: A 77-year-old woman with long-standing unilateral thoracic pain and incontinence". New England Journal of Medicine. 368 (9): 853–861. doi:10.1056/NEJMcpc1114034. PMID 23445097.