Fact-sheet: Perineural cyst


Updated on 02/13/2025 at 5:16 PM

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Definition

Tarlov perineural or perineural (perineural) cyst is a cystic dilatation between the perineurium and endoneurium of a nerve root, located between the spinal ganglion and the nerve root

It is an extradural arachnoid cyst containing a nerve root.

Clinical features

Most often asymptomatic, particularly when there is wide communication with the subarachnoid space.

May occasionally be symptomatic, especially if under pressure and/or enlarging:

  • lumboradicular pain occurring in flares, exacerbated by standing and Valsalva maneuvers,
  • paresthesias,
  • sacral pain,
  • perineal pain,
  • genitosphincteric disturbances,
  • rare intracranial hypotension in case of rupture.

MRI

Cystic image(s) of purely fluid signal, non-enhancing, sometimes multilobulated, surrounding a sacral, lumbar, thoracic, or cervical nerve root.

Possible scalloping of the adjacent neural foramen

Differential diagnosis

Cystic schwannoma