Association of Tarlov cyst with cauda equina syndrome and spinal cord infarction following caudal epidural block: A case report

被引:1
作者
Joo, Sunyoung [1 ]
Kim, Chung Reen [1 ,3 ]
Kim, Sunyoung [2 ]
机构
[1] Univ Ulsan, Ulsan Univ Hosp, Dept Rehabil Med, Coll Med, Jeonha 1 IL Dong, Ulsan, South Korea
[2] Univ Ulsan, Dept Neurol, Coll Med, Ulsan Univ Hosp, Jeonha 1 IL Dong, Ulsan, South Korea
[3] Univ Ulsan, Ulsan Univ Hosp, Dept Rehabil Med, Coll Med, 877 Bangeojinsunhwan Doro,Jeonha 1 IL Dong, Ulsan 44033, South Korea
关键词
case report; cauda equina syndrome; epidural injection; infarction; Tarlov cysts; CEREBRAL VASOSPASM; INJECTION; STENOSIS; PAIN;
D O I
10.1097/MD.0000000000035824
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Rationale:Caudal epidural block (CEB), which injects drugs into the epidural space through a sacral hiatus, is considered a safer alternative to other approaches. Serious complications, such as cauda equina syndrome or spinal cord infarction, have been reported very rarely, but their coexistence after CEB, which may be related to the ruptured perineural cyst, also known as a Tarlov cyst, was not reported.Patient concerns:A 40-year-old male patient presented with bilateral lower extremity radicular pain. CEB was performed without image guidance. The patient exhibited sensory deficits below L2, no motor function (0-grade), hypotonic deep tendon reflexes, and no pathological reflexes.Diagnoses:Spinal cord infarction, cauda equina syndrome, and sacral level perineural cyst with hemorrhage.Intervention:High doses of steroids and rehabilitation were performed.Outcomes:The patient was discharged after 28 days with persistent bilateral leg paralysis and sensory deficits below the L2 level. The patient demonstrated no neurological improvement.Lessons:Magnetic resonance imaging, including the sacral area, should be performed before performing CEB, to confirm the presence of a perineural cyst.
引用
收藏
页数:4
相关论文
共 24 条
  • [1] Caudal epidurals: the accuracy of blind needle placement and the value of a confirmatory epidurogram
    Barham, Guy
    Hilton, Andrew
    [J]. EUROPEAN SPINE JOURNAL, 2010, 19 (09) : 1479 - 1483
  • [2] Bicket MC, 2015, PAIN MANAG, V5, P129, DOI [10.2217/PMT.14.53, 10.2217/pmt.14.53]
  • [3] Complications Associated with Lumbar Transforaminal Epidural Steroid Injections
    Chang, Andrew
    Ng, Andrew T.
    [J]. CURRENT PAIN AND HEADACHE REPORTS, 2020, 24 (11)
  • [4] Size and aggregation of corticosteroids used for epidural injections
    Derby, Richard
    Lee, Sang-Heon
    Date, Elaine S.
    Lee, Joo-Han
    Lee, Chang-Hyung
    [J]. PAIN MEDICINE, 2008, 9 (02) : 227 - 234
  • [5] Confusion after spine injury: Cerebral fat embolism after traumatic rupture of a Tarlov cyst: Case report
    Duja C.M.
    Berna C.
    Kremer S.
    Géronimus C.
    Kopferschmitt J.
    Bilbault P.
    [J]. BMC Emergency Medicine, 10 (1)
  • [6] Cerebral Vasospasm: A Review
    Findlay, J. Max
    Nisar, Joshua
    Darsaut, Tim
    [J]. CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES, 2016, 43 (01) : 15 - 32
  • [7] Glaser Scott E, 2005, Pain Physician, V8, P309
  • [8] Goodman BS, 2008, CURR REV MUSCULOSKE, V1, P212, DOI 10.1007/s12178-008-9035-2
  • [9] Radicular Pain Followed by Epidural Blood Patch
    Jo, Daehyun
    Kim, Eung Don
    Oh, Hyun Jin
    Oh, Jin Young
    [J]. PAIN MEDICINE, 2014, 15 (09) : 1642 - 1643
  • [10] Caudal Epidural Block: An Updated Review of Anatomy and Techniques
    Kao, Sheng-Chin
    Lin, Chia-Shiang
    [J]. BIOMED RESEARCH INTERNATIONAL, 2017, 2017