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A 58 year-old woman presented pain in the low back radiating
down the right leg.
Sagittal MRI (Left) T1-weighted; (Right) T2-weighted. Note the cystic structure in the sacral area. This is a Tarlov cycst. Tarlov or perineurial cysts are pathological formations located in the space between the peri-and endoneurium of the spinal posterior nerve root sheath. These lesions have been estimated to affect between 4.6 and 9% of the adult population, and are most often found in the sacral region. Although originally believed by Tarlov to be asymptomatic lesions, these cysts, when present in the sacral neural canal and foramina, have since been found to cause a variety of symptoms, including radicular pain, paresthesias, and urinary or bowel dysfunction. Although the term Tarlov cyst has often been erroneously applied to other cystic spinal lesions, the distinctive feature of the Tarlov perineurial cyst is the presence of spinal nerve root fibers within the cyst wall, or the cyst cavity itself.
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