Complete Manuscript Title: Symptomatic Bilateral Cervical Perineural Cyst

Dharmadhikari, Rohit Prakash

doi:10.15406/mojor.2016.04.00127

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…In our case, the patient presented with symptoms of C7-C8 radiculopathy. In line with the previous studies, due to mild neurological manifestations, we initially treated her conservatively with a short course of oral cortisone and activity modification [9,12]. Due to the sufficient recovery, no further treatment was needed.…”

Section: Discussionmentioning

confidence: 66%

“…Aristeidis et al described a successful conservative approach with oral NSAIDs, soft cervical collar, and activity modification for the treatment of a symptomatic perineural cyst with only radicular symptoms [4]. Jain et al and Dharmadhikari and Gokhale reported the successful treatment of patients with radicular pain and sensory/motor deficits by employing oral steroid medication [9,12]. Several authors have also described successful relief in patients with symptomatic cervical perineural cysts and the presence of neurological symptoms after transforaminal epidural steroid injections (TFESI) [1,2].…”

Section: Discussionmentioning

confidence: 99%

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Successful Conservative Management of a Patient With Symptomatic Cervical Perineural Cysts: A Case Report

Stamiris,

Karampalis,

Stamiris

et al. 2024

Cureus

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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.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Successful Conservative Management of a Patient With Symptomatic Cervical Perineural Cysts: A Case Report

Stamiris,

Karampalis,

Stamiris

et al. 2024

Cureus

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Treatment of a symptomatic cervical perineural cyst with ultrasound-guided cervical selective nerve root block

Lee

Kim

2018

Medicine

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Rationale:Symptomatic cervical perineural cysts are extremely rare, and they cause radicular pain by compressing the cervical nerve root. Several methods have been applied to manage the radicular pain induced by cervical perineural cysts, including medication, percutaneous procedures, and surgery. However, these methods are associated with various outcomes and complications. The percutaneous procedure is simple and easy to perform, but if the perineural cyst wall is punctured, it can lead to secondary complications, which include aseptic meningitis and intracranial hypotension.Patient concerns:A 51-year-old woman presented with a dull pain in the left shoulder and a tingling sensation in the left dorsal arm, hand, and middle finger.Diagnosis:The patient was diagnosed with left C7 radicular pain caused by a perineural cyst.Interventions:The left C7 radicular pain did not respond to treatment with medication. Therefore, a left C7 nerve root block with local anesthetics and steroids was performed under ultrasound guidance. Adjunctively, real-time fluoroscopy with contrast was used to avoid intravascular injection.Outcome:The symptoms resolved without any complications.Lessons:In this case, perineural cyst-induced radicular pain, which was resistant to medication, was treated using ultrasound guided cervical selective nerve root block with local anesthetics and steroids. Ultrasound guidance can enable successful cervical selective nerve root block without perineural cystic wall puncture. Therefore, ultrasound-guided cervical nerve root block is an effective treatment option for radicular pain caused by a symptomatic perineural cyst.

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Complete Manuscript Title: Symptomatic Bilateral Cervical Perineural Cyst

Cited by 2 publications

References 17 publications

Successful Conservative Management of a Patient With Symptomatic Cervical Perineural Cysts: A Case Report

Successful Conservative Management of a Patient With Symptomatic Cervical Perineural Cysts: A Case Report

Treatment of a symptomatic cervical perineural cyst with ultrasound-guided cervical selective nerve root block

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