Giant Lumbosacral Tarlov Cyst With Extensive Presacral Extension: A Case Report And Review Of Literature
VOLUME 22, 2025
The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review
VOLUME 6, 2023
Mukhtar M. Shanqiti, BSc
Ahmed A. Alrehaili, MSc
Atif M. A. Osman, MD, FRCR
Aseel N. Alalawi, BSc
Abstract
Background: Tarlov cysts, or perineural cysts, are rare cerebrospinal fluid (CSF)-filled lesions most often found in the sacral region. Although frequently incidental, large or multiloculated cysts can cause mass effect or neurological symptoms. Recent analyses describe symptomatology and interventional decision-making in symptomatic cases.
Case Presentation: A 42-year-old male presented with a one-year history of dysuria and urinary frequency, followed by acute low back pain. CT imaging revealed large bilateral perisacral multiloculated cystic lesions with spinal canal extension. MRI confirmed a giant lumbosacral Tarlov cyst (11 × 9 cm) with multiple lumbar perineural cysts. The patient remained neurologically intact and was managed conservatively. Follow-up MRI after seven months showed stable cyst morphology without new findings. Recent case reports support effectiveness of tailored non-operative management in select patients.
Conclusion: This case highlights the imaging features and natural course of a lumbosacral Tarlov cyst managed conservatively, emphasizing the importance of individualized management guided by clinical presentation and neurological findings.
Keywords :
Tarlov cyst, perineural cyst, lumbosacral spine, MRI, presacral lesion, conservative management..
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.
Abstract
Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords :
Diabetic foot ulcer, angiosome, angioplasty