Tarlov Cysts

September 6,2011
Tarlov Cysts
(also known as perineural/perineurial) or
sacral nerve root cysts)

Contents
1. What is a Tarlov Cyst
2. Difference between valved and non-valved cyst
3-4. Symptoms
5. Magnetic Resonance Imaging
6-7. MRI images
8. Asymptomatic cysts to symptomatic cysts
9. Causes
10. Treatment
11. Bibliography

What are Tarlov Cysts?
- fluid-filled nerve root cysts
- most commonly in the sacral level of the spine
- typically occur along the posterior nerve roots
- can be valved or nonvalved
- distinguishing feature is presence of spinal nerve root
fibers within the cyst wall, or in the cyst cavity itself

What is a valved and non-valved
cyst?
A valved cyst has a structure in its neck that makes
it easier for spinal fluid to enter the cyst than to
leave.
A non-valved cyst, spinal fluid flows freely between
the cyst and the dural tube.

Symptomatic Tarlov Cysts
Symptoms:
● Pain in the area of the nerves affected by the cysts, especially the
buttocks
● Weakness of muscles
● Difficulty sitting for prolonged periods
● Loss of sensation on the skin
● Neurogenic claudication (pain in thigh due to lack of blood
supply)

Symptomatic Tarlov Cysts (continued)
● Changes in bowel function such as constipation
● Changes in bladder function including increased
frequency or incontinence
● Loss of reflexes
● Changes in sexual function
● Parathesias (abnormal sensations) in legs and feet or arms
and hands, dependent on cyst locations

Imaging of Tarlov Cysts
Magnetic Resonance Imaging (MRI) - dilated or
ballooned areas of the sheaths that cover nerve roots
exiting from the sacral region of the spinal column
Cysts
- created by the dilated sheaths of the nerve roots
- connected to the subarachnoid area
of the spinal column
- filled with cerebrospinal fluid

T-2 Weighted Imaging Preferred over T-1
Weighted Imaging
T 1
-weighted scans are:
● standard basic scan
● differentiate fat from
water (water darker and
fat lighter)
T 2
-weighted scans are:
● standard basic type
● differentiate fat from
water ( fat darker and
water lighter)
For example, CSF
(cerebrospinal fluid) will be
lighter in T 2
-weighted
images.

MRI image showing a Tarlov cyst.
Source: http://wiki.ask.com/Tarlov_cyst

MRI sagittal image of sacral and dorso-lumbar perineural cysts
Source: http://en.wikipedia.org/wiki/File:Tarlov_Cysts-Sagittal_MRI.JPG

Asymptomatic Cysts Can Become Symptomatic
due to traumatic injuries:
● falls
● automobile accidents
● heavy lifting
● childbirth
● epidurals

Causes of Tarlov Cysts
● Trauma to the spinal cord
● An increase in the CSF pressure
● A blockage of the CSF
● Herpes Simplex Virus outbreak can cause symptoms to
worsen

Other Imaging Techniques
Myelogram or Computed Tomography (CT)
- demonstrates the Cerebrospinal Fluid (CSF)
flow between the spinal subarachnoid area and the cyst
- determines how rapidly the cyst is filling and
whether or not the fluid is freely flowing in and/or
out of the cyst

Treatment for Tarlov Cysts
The cyst is opened and the cerebrospinal fluid drained
To prevent the fluid from returning, the cyst is occluded
with a fibrin glue injection

Bibliography
http://www.tarlovcystfoundation.org/TarlovCystInformation.asp
http://wiki.answers.com/Q/What_are_Tarlov_cysts
http://www.aans.org/JNSPG American Association of Neurological
Surgeons Article ID: 14496
http://go.galegroup.com (McCann Virtual Library)
http://drmorgan.info/Clinicians/TarlovsCyst.pdf
http://www.buzzle.com/articles/tarlov-cysts.html