Kümpers P, Wiesemann E, Becker H, Haubitz B, Dengler R, Zermann D-H
Abteilung Nephrologie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover.
Aktuelle Urol. 2006 Sep;37(5):372-5. doi: 10.1055/s-2005-919159.
Asymptomatic cysts of the sacral nerve roots display a prevalence of 5 % and are occasionally demonstrated by MRI of the spine. Depending on their size and localization, arachnoid cysts may cause sacral or perineal pain, radicular sensomotory symptoms and neurogenic bladder and bowel dysfunction by compression of the nerve roots.
We report on a case of a recently developed neurogenic bladder dysfunction. MRI of the spine demonstrated two large, liquor-filled cysts of 2.5 and 3 cm diameter, bilaterally localized at the nerve roots S2/3. Neurological and urological examinations confirmed the diagnosis of symptomatic nerve root cysts at the level S2/3, resulting in detrusor areflexia. A microsurgical excision of the cysts ameliorated the patient's pain symptoms. However, the detrusor areflexia did not improve.
Tarlov cysts are predominantly regarded an asymptomatic incidental feature of CT and MRI scans of the spine. The case of our patient, as well as the so far published reports indicate, however, that a Tarlov cyst may cause a variety of neurological and urological symptoms. Nerve root cysts should be seriously considered and not excluded at an early stage, especially when coincident with persistent neurological and urological symptoms.
骶神经根无症状囊肿的患病率为5%，偶尔在脊柱MRI检查中发现。根据其大小和位置，蛛网膜囊肿可能因压迫神经根而导致骶部或会阴部疼痛、神经根感觉运动症状以及神经源性膀胱和肠道功能障碍。
我们报告一例近期出现的神经源性膀胱功能障碍病例。脊柱MRI显示两个直径分别为2.5厘米和3厘米的大液性囊肿，双侧位于S2/3神经根处。神经科和泌尿科检查确诊为S2/3水平的有症状神经根囊肿，导致逼尿肌无反射。囊肿显微手术切除改善了患者的疼痛症状。然而，逼尿肌无反射并未改善。
塔洛夫囊肿主要被视为脊柱CT和MRI扫描的无症状偶然发现。然而，我们患者的病例以及迄今为止已发表的报告表明，塔洛夫囊肿可能导致各种神经和泌尿系统症状。神经根囊肿应被认真考虑，早期不应排除，尤其是当伴有持续的神经和泌尿系统症状时。
