Abstract:
Perineural cysts, also known as Tarlov cysts, are rare benign cerebrospinal fluid-filled cysts usually located at the junction of the posterior nerve root and the dorsal root ganglion and are usually asymptomatic. They are most commonly found in the sacral region and are uncommon in the cervical spine. Despite their rarity, symptomatic cases may present with neurological symptoms due to the compression of adjacent neurological structures. Symptomatic cervical perineural cysts are extremely rare, and there is limited consensus on management strategies. We present the case of a 56-year-old woman who presented with a four-week history of radicular symptoms involving the right C7 and C8 nerve roots, including neck and arm pain, paresthesias, and mild triceps weakness. Magnetic resonance imaging revealed two perineural cysts at the C6-C7 and C7-T1 levels. A conservative approach was chosen with a 14-day course of oral corticosteroids, use of a soft collar, and activity restrictions. Following this conservative treatment, a significant reduction in symptoms and complete neurological recovery were achieved. This case highlights the efficacy of conservative approaches in selected cases of mildly symptomatic cervical perineural cysts and contributes to a better understanding of management strategies for this condition.
摘要:
神经性囊肿,也被称为Tarlov囊肿,是罕见的良性脑脊液填充囊肿,通常位于后神经根和背根神经节的交界处,通常无症状。它们最常见于骶骨区域,在颈椎中并不常见。尽管它们很少,有症状的病例可能由于邻近神经结构的压迫而出现神经症状。症状性宫颈神经周围囊肿极为罕见,关于管理策略的共识有限。我们介绍了一名56岁的女性,她有四周的神经根症状史,涉及右C7和C8神经根,包括颈部和手臂疼痛,感觉异常,和轻微的三头肌无力.磁共振成像显示在C6-C7和C7-T1水平有两个神经囊肿。选择了保守的方法,口服皮质类固醇14天的疗程,使用柔软的领子,和活动限制。经过这种保守治疗,症状显著减轻,神经系统完全恢复.此病例强调了保守方法在某些轻度症状的宫颈神经周囊肿病例中的疗效,并有助于更好地了解这种情况的管理策略。