Smith Brandon W, Jack Megan M, Powell Garret M, Frick Matthew A, Amrami Kimberly K, Spinner Robert J
Departments of Neurological Surgery and.
Radiology, Mayo Clinic, Rochester, Minnesota.
J Neurosurg Case Lessons. 2021 May 24;1(21):CASE21130. doi: 10.3171/CASE21130.
The advancement of high-resolution imaging and increased clinical experience have led to an increased understanding of the formation and treatment of intraneural ganglion cysts. Nearly all intraneural ganglion cysts in the common peroneal nerve have been reported to arise from a joint connection to the superior tibiofibular joint. The authors have identified four cases of intraneural ganglion cysts arising from the knee joint itself; however, none of these reported cases were well described, documented, or illustrated with high-resolution imaging.
Here the authors present the case of an intraneural ganglion cyst arising from the knee joint and causing intermittent weakness and pain. The articular branch to the knee joint was clearly demonstrated on high-resolution magnetic resonance imaging and confirmed at surgical exploration. The patient was treated with articular branch ligation and has had complete resolution of his symptoms without recurrence of the cyst on follow-up imaging.
This case adds to the mounting evidence that intraneural cyst pathology is dependent on a connection to a synovial joint as stated in the unifying theory of intraneural cyst development.
高分辨率成像技术的进步以及临床经验的增加，使得人们对神经内腱鞘囊肿的形成和治疗有了更深入的了解。据报道，几乎所有腓总神经内的神经内腱鞘囊肿都起源于与胫腓上关节的关节连接。作者已经确定了4例起源于膝关节本身的神经内腱鞘囊肿病例；然而，这些报道的病例均未得到充分描述、记录或用高分辨率成像进行说明。
在此，作者报告了1例起源于膝关节并导致间歇性无力和疼痛的神经内腱鞘囊肿病例。在高分辨率磁共振成像上清晰显示了膝关节的关节支，并在手术探查中得到证实。患者接受了关节支结扎治疗，症状完全缓解，随访成像显示囊肿未复发。
该病例进一步证明了神经内囊肿病理学依赖于与滑膜关节的连接，这正如神经内囊肿发展的统一理论所述。
