Introduccion

Introduction



Tarlov cysts are spinal nerve root lesions filled with spinal fluid, found most often at the lower levels of the spine. Tarlov cysts can be asymptomatic or cause a potentially serious neurological disease. Preliminary studies suggest that about 1% of sciatic or sciatic-like symptoms may be caused by Tarlov cysts. Other names for Tarlov and related spinal cysts are perineural or perineurial cyst, meningeal cyst, and arachnoid cyst.

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A propensity for developing Tarlov cysts may be passed through the mother or father. Tarlov cysts are most often found when the lumbar and sacral levels of the spine are scanned by MRI for other conditions.
Even though present, these cysts usually cause no apparent symptoms. However, Tarlov cysts have frequently been dismissed by radiologists as "incidental" even though the patients have symptoms that could be caused by a Tarlov cyst. Iin such cases, Tarlov cyst cannot be eliminated by radiology.
Symptoms may be initiated by trauma incurred in an event such as a fall, auto accident or heavy lifting. The onset may be gradual or sudden, mild or severe, and the progression and ultimate severity of symptoms differ widely. Tarlov cysts in the disease stage usually cause pain neurological dysfunction in the path of the affected nerve root.
Tarlov cysts differ in structure. A cyst might incorporate nerve elements or be free of them. A cyst can be valved or non-valved. A valved cyst has a structure in its neck that makes it easier for spinal fluid to enter the cyst than to leave. In a non-valved cyst, spinal fluid flows freely between the cyst and the dural tube.
Tarlov cysts are typically on posterior roots; anterior cysts are rare. Multiple Tarlov cysts are not uncommon. Although a large cyst can cause symptoms by pressing on an adjacent structure, symptoms may also be caused by hydrostatic forces of the spinal fluid inside the cyst exerting pressure on nerves in the cyst or cyst wall.1 The pulsations of spinal fluid causes the cyst to expand, potentially stretching nerve elements and causing or increasing symptoms.2 Therefore, cysts even smaller than one centimeter can be highly symptomatic.
The most common symptoms are pain in the low back, buttocks and legs, but the thighs, legs and feet may or may not be involved.3 Symptoms can be opposite-sided. Tarlov cysts can also cause pain and disorders in the organs of elimination and reproduction, hypoesthesia, paresthesias, and neurogenic claudication (pain in the thigh from lack of blood supply).4 The postures of sitting, standing, walking, and bending are typically painful, and reclining flat on the side is usually the only posture that offers relief.
A person who has a Tarlov cyst and any Tarlov cyst symptom needs evaluation by a specialist who has the expertise to determine if the symptoms are from a Tarlov cyst or another spine condition. However, few specialists are familiar with the full scope of Tarlov cyst symptomology and recent advances in treatment.
A variety of surgical techniques have been employed for Tarlov cysts, but it is extremely rare for a surgeon to have operated on a substantial number of Tarlov cysts with benefit to most patients.
A minimally invasive procedure for Tarlov cysts involves aspiration of the cyst followed by injection of fibrin glue ("AFGI"). This procedure has been effective for some members. The leading centers for treatment of Tarlov cysts (Johns Hopkins University, Baltimore, and University Louis Pasteur, Strasbourg) try AFGI on suitably valved cysts before resorting to surgery.
For MRI of Tarlov cysts, interventional neuroradiologist Dr. M. R. Patel recommends scanning axially through the cyst and, post-operatively, to obtain pre- and post-Gadolinium axial images.

Neurology India
Inasmuch as the disease is rare, the number of Tarlov cysts treated in any part of the world is small. Therefore, international cooperation will be crucial to the evaluation and refinement of promising new treatments. Research grants from national government are typically allocated to the more common diseases. At this time, we are accepting donations from patients and other benefactors and philanthropists, to a fund that will enable us to invite and facilitate meetings with regard to potential collaboration on Tarlov cysts between the University Louis Pasteur, Strasbourg, France. and the top-rated American hospital, Johns Hopkins, of Baltimore, Maryland, and the world's top Tarlov cyst experts who are affiliated with these institutions.

copiado de la web
http://www.tarlovcyst.org/index.php?option=com_content&task=view&id=21&Itemid=68