[Sacral nerve root cysts--a rare cause of bladder dysfunction. Case report and review of the literature].
BACKGROUND
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.


METHODS
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.


CONCLUSIONS
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.
Kümpers
P
P
Abteilung Nephrologie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover. pkuempers@htp-tel.de
Wiesemann
E
E
Becker
H
H
Haubitz
B
B
Dengler
R
R
Zermann
D-H
DH
D016080:Arachnoid Cysts / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008866:Microsurgery; D008875:Middle Aged; D009192:Myelography; D009408:Nerve Compression Syndromes / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012447:Sacrum; D013126:Spinal Nerve Roots / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery