Symptomatic cervical perineural (Tarlov) cyst: a case report.

Introduction: Perineural cysts, also known as Tarlov cysts, are benign cerebrospinal fluid-filled cysts of the spinal cord. They were first described by IM Tarlov in 1938. Case presentation: We describe a Tarlov cyst located in the cervical spine, a location quite rare in literature. The patient is a 44-year-old woman who presented with a 3-week history of radicular symptoms of the right C6 root. A perineural cyst was identified at the C5-6 level after Magnetic Resonance Imaging of the cevical spine. A conservative approach was chosen, with the use of a soft collar for two weeks, a 15-day course of oral non-steroidal anti-inflammatory medication and specific instructions concerning limitation of her activities. After two weeks of this conservative treatment the patient had no pain and 90% improvement of her numbness. During 12 months follow up she was satisfied with no pain, no recurrent symptoms and no need for any additional treatment. Conclusions: In this case report, we include a different clinical and therapeutic approaches of Tarlov cysts, regardless of their location (lumbosacral, cervical). This is the first case report of a cervical Tarlov cyst treated conservatively without the use of oral or injected steroids. We would also like to suggest the inclusion of a perineural cyst in the differential diagnosis of any patient presenting with radicular symptoms. Finally, we discuss briefly any literature that we considered relevant in history, diagnosis and treatment of perineural cysts.