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Dilatation of arachnoid and dura of spinal posterior nerve root sheath, containing nerve fibers
a.k.a. Tarlov cyst
Occur anywhere along spine
Most common in lower lumbar spine and sacrum
S2 and S3 nerve roots most commonly involved
Thin-walled cyst mass
Contents follow cerebrospinal fluid (CSF) density/signal intensity
No enhancement
± neural foraminal widening (bone remodeling)
Facet synovial cyst
Nerve sheath tumor
Spinal nerve root avulsion
Meningocele
Nabors classification of spinal meningeal cyst (MC)
Type I: Extradural MC without spinal nerve root fibers
IA: Extradural MC
IB: Occult sacral meningocele (outdated term)
Type II: Extradural MC with spinal nerve root fibers
Type III: Intradural MC
Majority asymptomatic: > 80%
Symptoms may worsen with postural changes, Valsalva maneuvers
Cyst rupture → spontaneous intracranial hypotension
Symptoms simulate disc herniation and spinal stenosis
CSF intensity mass enlarging neural foramen or sacral canal characteristic of perineural root sleeve cyst
Spinal nerve root diverticulum
Tarlov cyst
Perineural cyst
Dilatation of arachnoid and dura of spinal posterior nerve root sheath, containing nerve fibers
Best diagnostic clue
Thin-walled cerebral spinal fluid (CSF) density/intensity masses extending into/through neural foramina
Location
Anywhere along spinal axis
Most common in lower lumbar spine and sacrum
S2 and S3 nerve roots most commonly involved
Size
Variable
Morphology
Well circumscribed
Thin-walled cystic mass
Round, lobular, multiloculated
Often multiple and bilateral
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