Abstract
Tarlov’s cysts (TC) are benign dilations of the spinal nerve root sheaths that can arise all along the spine, more frequently at sacral level. In the majority of cases, TC are incidental and asymptomatic, but they can cause a large variety of symptoms if there is an increase in their size or if rupture or intracystic haemorrhage occurs. We present the case of a 55-year-old woman with sciatica-like pain ensuing from rupture and intracystic bleeding of a Tarlov’s cyst after a lumbo-sacral trauma due to a syncope. Tarlov’s cysts can cause a wide variety of symptoms. In our case, the rupture and intracystic haemorrhage of the Tarlov’s cyst caused a sciatica-like pain. We were able to ascertain the presence of an intracystic haemorrhage thanks to a previous MR in which the cyst had CSF-like content.
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References
Tarlov IM. Perineurial cysts of the spinal nerve roots. Arch Neurol Psychiatry. 1938;40:1067–74.
Nabors MW, Pait TG, Byrd EB, Karim NO, Davis DO, Kobrine AI, Rizzoli HV. Updated assessment and current classification of spinal meningeal cysts. J Neurosurg. 1988;68(3):366–77.
Neulen A, Kantelhardt SR, Pilgram-Pastor SM, et al. Microsurgical fenestration of perineural cysts to the thecal sac at the level of the distal dural sleeve. Acta Neurochir. 2011;153:1427–34.
Mummaneni PV, Pitts LH, McCormack BM, et al. Microsurgical treatment of symptomatic sacral Tarlov cysts. Neurosurgery. 2000;47:74–8.
Klepinowski T, Orbik W, Sagan L. Global incidence of spinal perineural Tarlov’s cysts and their morphological characteristics: a meta-analysis of 13,266 subjects. Surg Radiol Anat. 2021;43:855–63.
Kong WK, Cho K-T, Hong S-K. Symptomatic Tarlov cyst following spontaneous subarachnoid hemorrhage. J Korean Neurosurg Soc. 2011;50:123–5. https://doi.org/10.3340/jkns.2011.50.2.123.
Akahori S, Nishimura Y, Eguchi K, Nagashima Y, Ando R, Awaya T, Hara M, Natsume A. Spontaneous rupture of a huge presacral Tarlov cyst leading to dramatic neurologic recovery. World Neurosurg. 2021;145:306–10. https://doi.org/10.1016/j.wneu.2020.09.098.
Voyadzis J-M, Bhargava P, Henderson FC. Tarlov cysts: a study of 10 cases with review of the literature. J Neurosurg (Spine 1). 2001;95:25–32.
Soon WC, Sun R, Czyz M. Haemorrhagic Tarlov cyst: a rare complication of anticoagulation therapy. Oxford Med Case Rep. 2021;8:294–5. https://doi.org/10.1093/omcr/omab063.
Kain K II, Jain N, O’ Brien K. Findings of subarachnoid fat after trauma to a Tarlov cyst. Radiol Case Rep. 2021;16:258–61. https://doi.org/10.1016/j.radcr.2020.10.056.
Zubizarreta IK, Sánchez Menoyo JL, Ojeda JR, Olabarria IV, García-MoncóCarra JC. Cerebral fat embolisms secondary to rupture of a Tarlov cyst. Neuroimaging. 2014;24:432–3. https://doi.org/10.1111/j.1552-6569.2012.00782.
Duja CM, Berna C, Kremer S, Géronimus C, Kopferschmitt J, Bilbault P. Confusion after spine injury: cerebral fat embolism after traumatic rupture of a Tarlov cyst: Case report. BMC Emerg Med. 2010;10:18. https://doi.org/10.1186/1471-227X-10-18.
Inghilleri M-L, Ancuta S, Azakri S, Lippi A, Renard D. Traumatic intracranial hypotension due to a Tarlov cyst tear. Acta Neurol Belg. 2016;116:193–4. https://doi.org/10.1007/s13760-015-0515-z.
Yates JR, Jones CS, Stokes OM, Hutton M. Incomplete cauda equina syndrome secondary to haemorrhage within a Tarlov cyst. BMJ Case Rep . 2017;2017:bcr2017219890. https://doi.org/10.1136/bcr-2017-219890.
Godel T, Pham M, Wolff M, Bendszus M, Bäumer P. Tarlov cyst haemorrhage causing acute radiculopathy: a case report. Clin Neuroradiol. 2018;28:123–5. https://doi.org/10.1007/s00062-017-0597-5.
Sudhakar T, Désir LL, Ellis JA. Tarlov cyst rupture and intradural haemorrhage mimicking intraspinal carcinomatosis. Cureus. 2021;13(6):e15423. eCollection 2021 Jun. https://doi.org/10.7759/cureus.15423.
Caspar W, Papavero L, Nabhan A, Loew C, Ahlhelm F. Microsurgical excision of symptomatic sacral perineurial cysts: a study of 15 cases. Surg Neurol. 2003;59:101–5.
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All authors contributed to the study conception and design. Material preparation and data collection were performed by Dr. Davide Gadda, MD, and Dr. Cesare Pandolfo, MD. The first draft of the manuscript was written by Dr. Sara Imreh, MD, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Imreh, S., Gadda, D., Pandolfo, C. et al. Post-Traumatic Haemorrhagic Tarlov’s Cyst: a Case Report and Review of Literature. SN Compr. Clin. Med. 5, 55 (2023). https://doi.org/10.1007/s42399-023-01387-2
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DOI: https://doi.org/10.1007/s42399-023-01387-2