Siquara de Sousa Ana C, Capek Stepan, Howe Benjamin M, Jentoft Mark E, Amrami Kimberly K, Spinner Robert J
Departments of 1 Neurosurgery.
International Clinical Research Center, St. Anne's University Hospital Brno, Czech Republic.
Neurosurg Focus. 2015 Sep;39(3):E15. doi: 10.3171/2015.6.FOCUS15208.
Sciatic nerve endometriosis (EM) is a rare presentation of retroperitoneal EM. The authors present 2 cases of catamenial sciatica diagnosed as sciatic nerve EM. They propose that both cases can be explained by perineural spread of EM from the uterus to the sacral plexus along the pelvic autonomie nerves and then further distally to the sciatic nerve or proximally to the spinal nerves. This explanation is supported by MRI evidence in both cases. As a proof of concept, the authors retrieved and analyzed the original MRI studies of a case reported in the literature and found a similar pattern of spread. They believe that the imaging evidence of their institutional cases together with the outside case is a very compelling indication for perineural spread as a mechanism of EM of the nerve.
坐骨神经子宫内膜异位症（EM）是腹膜后EM的一种罕见表现形式。作者报告了2例被诊断为坐骨神经EM的经期性坐骨神经痛病例。他们提出，这两例病例都可以通过EM沿盆腔自主神经从子宫向骶丛神经的神经周围扩散来解释，然后进一步向远端扩散至坐骨神经或向近端扩散至脊神经。这一解释在两例病例中均得到了磁共振成像（MRI）证据的支持。作为概念验证，作者检索并分析了文献中报道的一例病例的原始MRI研究，发现了类似的扩散模式。他们认为，其机构病例以及外部病例的影像学证据非常有力地表明神经周围扩散是神经EM的一种机制。
