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Recognition of peroneal intraneural ganglia in an historical cohort with “negative” MRIs

  • Original Article - Neurosurgical Anatomy
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Abstract

Background

The objective of this study was to review an historical cohort of patients with peroneal neuropathy and magnetic resonance imaging (MRI) read as negative for mass or cyst to determine if occult peroneal intraneural ganglion cysts can be identified on subsequent imaging review and to use this as an estimation of how under-recognized this pathologic entity is.

Method

The patient cohort utilized in this study was a previously published control cohort of 11 patients with peroneal neuropathy and MRI read as negative for mass or cyst. Clinical history, neurologic examination, and MRI studies of the knee were reviewed for each of the included patients. The primary outcome of interest was the presence of peroneal intraneural ganglion cyst on MRI.

Results

Overall, 7 of 11 (64%) patients in this historical “normal” cohort had evidence of a peroneal intraneural ganglion cyst on subsequent review of imaging. Deep peroneal-predominant weakness, knee pain, and tibialis anterior-predominant denervation/atrophy were seen more commonly in patients in whom an intraneural cyst was identified.

Conclusions

This retrospective cohort study provides evidence that peroneal intraneural ganglion cysts are an historically under-recognized cause of peroneal neuropathy, with 64% of this historical “negative” cohort having evidence of a cyst on subsequent imaging review. Larger studies are needed to determine the treatment ramifications of identifying small cysts and to determine the clinical features suggestive of an intraneural ganglion cyst.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert J. Spinner.

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Conflicts of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Funding

No funding was received for this research.

Ethical approval/Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Comments

A very scholarly article on an entity that this group discovered and continue to mine.

Michel Kliot

CA, USA

Thomas J. Wilson and Marie-Nöelle Hébert-Blouin made an equal contribution to this manuscript

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Wilson, T.J., Hébert-Blouin, MN., Murthy, N.S. et al. Recognition of peroneal intraneural ganglia in an historical cohort with “negative” MRIs. Acta Neurochir 159, 925–930 (2017). https://doi.org/10.1007/s00701-017-3130-3

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  • DOI: https://doi.org/10.1007/s00701-017-3130-3

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