Pfund N, Oh A, Cyna A
Nepean Hospital, Derby St, Kingswood, NSW, Australia.
Nepean Hospital, Derby St, Kingswood, NSW, Australia.
Int J Obstet Anesth. 2018 May;34:96-98. doi: 10.1016/j.ijoa.2017.10.004. Epub 2017 Dec 15.
Perineural (Tarlov) cysts are cerebrospinal fluid-containing perineural sacs that are usually located in the sacral spine. While often asymptomatic, they can cause progressive neurological symptoms including pain, paraesthesia and weakness. We present a case of a 24-year-old patient who had uneventful spinal anaesthesia at the L3-4 level for an elective caesarean section. Prior to her procedure, she had reported a two-year history of intermittent back pain and lower-limb paraesthesia, secondary to an S1 segment perineural cyst. Recurrent cyst-related symptoms were managed using serial radiologically-guided injection and cerebrospinal fluid aspiration, rather than a more invasive neurosurgical approach. Successful neuraxial anaesthesia for caesarean section, in the context of Tarlov cysts, is described; and the management options are discussed.
神经周围（塔尔洛夫）囊肿是含有脑脊液的神经周围囊袋，通常位于骶椎。虽然它们通常无症状，但可引起进行性神经症状，包括疼痛、感觉异常和无力。我们报告一例24岁患者，她在L3 - 4水平接受择期剖宫产术时进行了顺利的脊髓麻醉。在手术前，她报告有两年间歇性背痛和下肢感觉异常病史，继发于S1节段神经周围囊肿。复发性囊肿相关症状采用系列放射学引导注射和脑脊液抽吸治疗，而非更具侵入性的神经外科方法。本文描述了在塔尔洛夫囊肿情况下剖宫产术成功的椎管内麻醉，并讨论了治疗选择。
