Tarlov cysts: symptoms, causes and treatment

Sometimes and due to certain types of organic anomalies, our body produces and develops a series of abnormal masses formed by membranous bags that house substances or liquid elements that the self produces body. Although in most cases they do not pose a danger to the physical integrity of the person, their effects can be quite annoying. This is the case of Tarlov cysts, some abnormal formations that can appear in the lumbar or sacral zone.

Throughout this article we will talk about the characteristics of these malformations, as well as the symptoms that are associated with them, their causes and possible treatments.

• Related article: "Meninges: anatomy, parts and functions in the brain"

What are Tarlov cysts?

Also diagnosed under the label of perineural, periradicular, or extradural arachnoid cysts, Tarlov cysts constitute small bodies and inside which they house a small amount of cerebrospinal fluid.

These cysts are formed by a dilation of the dura mater, so they are classified as a pathology of this. These are anomalous formations that also have

a stalk or extension that keeps them connected to the spinal subarachnoid space, also being located around the nerves of the sacral and lumbar area which are pressed or compressed by these cysts.

Despite the fact that, as just mentioned, Tarlov cysts usually affect the nerves located in the area lower vertebral column, these anomalous bodies are completely asymptomatic in the first phase su development. That is, they do not have to lead to the appearance of symptoms that give them away.

However, in cases in which the person suffers some trauma or inflammation, or when the compression of the nerves is very severe, the patient may experience pain in the areas lumbar. As well as symptoms of sciatica, urinary incontinence or headaches among many others that will be mentioned in the next point.

These pathological formations of the dura mater, which They are named after the American neurosurgeon Isadore Tarlov.They have a much higher incidence in women and their symptoms can be reduced through an alkaline diet or diet, among many other treatments.

What is the symptomatology?

The main characteristic of Tarlov cysts is that they are usually asymptomatic, in at least 70% of the people who suffer from them. However, in other cases they can be highly annoying.

Due to the discretion with which they develop, in most cases they are accidentally discovered when the person performs some type of neuroimaging test like a nuclear magnetic resonance and tend to be evaluated as formations without any kind of importance pathological.

In some cases, during the early stages of its formation, symptoms may appear that develop either gradually or, on the contrary, it may appear. a painful clinical picture, suddenly. Likewise, the severity or intensity with which the symptoms affect the person will depend to a large extent on the size to which the Tarlov cysts develop.

In most patients, symptoms begin with mild pain experienced at the same level as the cyst, followed by a series of alterations in all those organs or functions related to the nerve on which the pressure is exerted.

Although at first they do not pose a threat or danger to the person's physical health, without effective treatment, Tarlov cysts can cause Very severe complications that seriously compromise the quality of life of the patient, who is susceptible to developing any type of dependency or physical disability, both partial as complete.

Among the main symptoms that can manifest are:

• Pain in the lower back or sabra.
• Sciatic pain.
• Pain at the level of the buttocks.
• Hip pain.
• Muscle pain in the thighs due to reduced blood flow.
• Complications in the excretory organs.
• Alterations in the reproductive organs.
• Decreased sensitivity or hypoesthesia.
• Tingling sensation or paresthesia.

As a consequence, people with Tarlov cysts experience great difficulty carrying out certain movements or postures such as standing up or trying to sit down. In the same way, walking bending over or lying down can be a great torment due to the painful sensations they cause.

What causes does it have?

At the moment, a completely reliable cause of Tarlov cysts has not been able to be established. However, over time different theories have been developed whose main hypotheses relate these cysts to a traumatic, congenital and hemorrhagic origin.

1. congenital hypothesis

This first theory points to the idea that certain irregularities in the formation of membranes that surround the brain known as the meninges may be the main cause of the formation of these cysts; O well a congenital abnormality in the most superficial of these membranes, the dura mater;

2. traumatic hypothesis

On the other hand, the traumatic hypothesis describes that injuries caused by spinal punctures, anesthesia applied in the epidural area or in the spinal area, as well as traumatisms that affect the sacral area They can also be the origin of the appearance of these masses of cerebrospinal fluid.

3. hemorrhagic hypothesis

As its name indicates, the hemorrhagic hypothesis is sustained on the assumption that the cyst It is caused by a subarachnoid hemorrhage..

How can it be diagnosed?

As previously pointed out, in most cases Tarlov cysts They are usually diagnosed accidentally when the person undergoes some type of neuroimaging test. carried out in the area where the masses are located.

However, in cases where the person begins to experience the first symptoms functional magnetic resonance imaging will be required. In addition, in order to rule out the possibility that it is any other type of condition, you must perform a computerized myelogram that reveals a connection between the cyst and the space subarachnoid.

Is there a treatment?

The choice of one of the possible treatments that exist for Tarlov cysts is subject to the type of effects and symptoms experienced by the patient, as well as the size of the cyst and the results of tests physical.

In smaller cysts that do not cause very large or bothersome symptoms, intervention is usually resorted to through physiotherapy, together with the administration of anti-inflammatory medication or analgesic. Recent studies have revealed that the gabapentin, traditionally used for the treatment of epilepsy and neuropathic pain, turns out to be highly effective in reducing the effects of cysts.

However, in those more serious cases, it is very possible that the patient must undergo an intervention through surgery. Using a technique known as fenestration, the surgeon can puncture the cyst and drain the cerebrospinal fluid which is inside. Then we proceed to seal it to avoid the possibility of the liquid filling it up again.

Finally, a treatment that has been quite effective in relieving the pain of Tarlov cysts is transcutaneous electrical nerve stimulation. An intervention that does not have side effects and that consists of the application of small electrical currents through the skin.