Tarlov Cyst

What is the history of Tarlov Cyst?

When was Tarlov Cyst discovered? What is the story of this discovery? Was it coincidence or not?

Tarlov cyst, also known as perineural cyst or sacral nerve root cyst, is a rare condition that involves the formation of fluid-filled sacs on the nerve roots of the spine. These cysts are typically found in the sacral region of the spine, which is the lower back area.

The history of Tarlov cyst dates back to the early 20th century when they were first discovered by Dr. Isadore Tarlov, a neurologist and pathologist. In 1938, Dr. Tarlov published a study describing these cysts and their association with nerve root compression and related symptoms.

Initially, Tarlov cysts were thought to be congenital in nature, meaning they were present at birth. However, further research has shown that they can also develop later in life due to trauma, degenerative changes in the spine, or increased pressure within the spinal canal.

The exact cause of Tarlov cysts is still not fully understood. Some theories suggest that they may result from a weakness in the connective tissue surrounding the nerve roots, allowing the cysts to form. Others propose that they may be related to abnormalities in the lymphatic system or increased cerebrospinal fluid pressure.

Tarlov cysts are typically asymptomatic, meaning they do not cause any noticeable symptoms in most cases. However, when symptoms do occur, they can vary widely depending on the size and location of the cysts. Common symptoms include:

Chronic pain in the lower back, buttocks, or legs

Weakness or numbness in the legs

Bladder or bowel dysfunction

Sexual dysfunction

Diagnosing Tarlov cysts can be challenging as they are often discovered incidentally during imaging tests performed for other reasons. Magnetic resonance imaging (MRI) is the most effective tool for visualizing these cysts and determining their size and location.

Treatment options for Tarlov cysts are limited and primarily focused on managing symptoms. Conservative approaches such as pain medication, physical therapy, and lifestyle modifications are often recommended as the first line of treatment. In some cases, minimally invasive procedures such as cyst aspiration or surgical removal may be considered if symptoms are severe and significantly impacting the patient's quality of life.

Despite ongoing research, there is still much to learn about Tarlov cysts. The rarity of the condition and the lack of standardized diagnostic criteria and treatment guidelines contribute to the challenges in understanding and managing this condition effectively.

by Diseasemaps

Dr. Isadore Max Tarlov is especially remembered for his 1938 description of the eponymous perineural 'Tarlov cyst', discovered during an autopsy study. (Tarlov IM: Perineurial cysts of the spinal nerve roots, Arch Neurol Psych 40:1067–1074, 1938). Unfortunately, his first publication is still rememberd, and which appeared in the textbooks. The words "not of clinical significance" or "incidental finding" are still referred to among physicians, and with these words still patients are send off home, without proper examination and diagnosis (with the mere few). But does Tarlov wrote that they were incidental findings? His 1938 article states, "although the cysts did not appear to have clinical significance in these cases, one wonders whether they are not responsible for the discomfort in certain cases of sciatica or nerve root pain in which other pathological basis is excluded. This awaits further studies with clinical and pathological correlations'. Furthermore, pathological examination showed that the Tarlov cysts gave degenerative changes and that there was a failure of nerve cells in the corresponding ganglion. What is the definition of an incidental finding? An incidental finding is "a finding concerning an individual research participant who has potential health or reproducivity interest and is discovered while conducting research, but falls outside the scope of the study" (Wolf, Managing Incidental Findings in Human Subjects Research, J Law Med Ethics, 2008). What is an individual research participant? Research, specifically aimed at one person. The tarlov study involved an autopsy study of the filum terminal of 30 adult subjects, in which he had found perineural cysts. Cysts that were already found by Marburg, who described 4 cases (1902) of cysts of the spinal ganglia. The cysts were solitary in 3 cases and several in the fourth. Hinrichs (1932) recorded a case in which 3 cysts occurred on the posterior thoracic and lumbar roots, in the area of crossing the root and ganglion. The exact location of origin of the cysts were not determined by either in the reported cases. Most doctors tell patients, that these cysts are only 'incidental findings' or clinaccaly not relevant. Dr. Tarlov found this experience worth capturing, especially since in these cases it was possible to determine the place of origin of the cysts. You can't really call the 'discovery' of these cysts incidental, research involved 30 adult and in which these cysts were observed in 5 cadavers You can not call these cysts not relevant, in his study Tarlov wrote: In cases where nerve fibres or ganglion cells completely or partially surrounded the cyst, evidence of degenerative changes was present. Disintegration of myelin shells and nerve fibers was seen in Refuse-Pal and Gros-Bielschowsky preparations and cresyl violet spots revealed chromatosis (a reactive change that occurs in the cell body of damaged neurons) of ganglion cells. Accumulations of phagocytes (white blood cells) filled with fat or blood pigment occurred, and mucicarmine revealed a few drops of mucine in large round cells. There was failure of nerve cells in the corresponding ganglion, with prolefartion (growth) of fibroblasts and formation of connective tissue scars. You can hardly call this not relevant

7/23/21 by Stichting Overdruksyndroom NL

I’m not sure of the history

10/29/17 by Karen 2500

See Tarlov Cyst Disease

1/20/18 by dhedge42 2500

Dr Tarlov diagnosed it in 1938

6/18/18 by MissLeanneM 1700

Tarlovs were discovered in the early 1900s,. Or atleast that is when they were named. Name given to them by a Dr Tarlov. In recent textbooks they are given a whole chapter to themselves, before they receive a paragraph.

6/18/18 by Ze 2520

I believe it was a man named tarlov who was a doctorate in 1937 who actually stated that these cysts were incidental finding and did not cause pain. He was very wrong

6/19/18 by Debbie Dronfield 2500

Isadore Max Tarlov, an early neurosurgeon, made several important contributions to the field of spine surgery. He described sacral perineural cysts, now known as Tarlov cysts. Dr. Tarlov also introduced the knee-chest patient position to facilitate exposure and hemostasis in lumbar surgery. In addition, he developed the use of fibrin glue in nerve repair.

6/19/18 by Lynn 2500

Tarlov was a doctor who discovered the cysts in 1938.

12/10/19 by Jess Carhart 2500

Isadore M. Tarlov, M.D., in 1938

7/22/21 by Michelle Tamplin 2500

Dr. Isadore Max Tarlov is especially remembered for his 1938 description of the eponymous perineural 'Tarlov cyst', discovered during an autopsy study. (Tarlov IM: Perineurial cysts of the spinal nerve roots, Arch Neurol Psych 40:1067–1074, 1938). Unfortunately, his first publication is still rememberd, and which appeared in the textbooks. The words "not of clinical significance" or "incidental finding" are still referred to among physicians, and with these words still patients are send off home, without proper examination and diagnosis (with the mere few). BUT DID TARLOV WROTE THAT THEY WERE INCIDENTAL FINDINGS AND OF CLINICAL SIGNIFICANCE? NO - HE DID NOT What is the definition of an incidental finding? An incidental finding is "a finding concerning an individual research participant who has potential health or reproducivity interest and is discovered while conducting research, but falls outside the scope of the study" (Wolf, Managing Incidental Findings in Human Subjects Research, J Law Med Ethics, 2008). The tarlov study involved an autopsy study of the filum terminal of 30 adult subjects, in which he had found perineural cysts. Cysts that were already found by Marburg, who described 4 cases (1902) of cysts of the spinal ganglia. The cysts were solitary in 3 cases and several in the fourth. Hinrichs (1932) recorded a case in which 3 cysts occurred on the posterior thoracic and lumbar roots, in the area of crossing the root and ganglion. The exact location of origin of the cysts were not determined by either in the reported cases. Dr. Tarlov found this experience worth capturing, especially since in these cases it was possible to determine the place of origin of the cysts. YOU CAN'T REALLY CALL THE DISCORVERY OF THESE CYSTS INCIDENTAL, RESEARCH INVOLVED 30 CADAVERS OF ADULTS AND IN WICH THESE CYSTE WERE FOUND IN 5 OF THEM. What did dr. Tarlov find out more in his first study? Tarlov: as far as I was aware of, no symptoms or signs referring to cysts. Although the cysts did not appear to have clinical significance in these cases, one wonders whether they are not responsible for the discomfort in certain cases of sciatica or nerve root pain in which other pathological causes are excluded. This awaits further studies with clinical and pathological correlations. Histological examination of the cyst showed no evidence of recent or ancient bleeding, which, if present, would have explained a traumatic origin. In cases where nerve fibres or ganglion cells completely or partially surrounded the cyst, EVIDENCE OF DEGENERATIVE CHANGES WAS PRESENT. Disintegration of myelin shells and nerve fibers was seen in Refuse-Pal and Gros-Bielschowsky preparations and cresyl violet spots revealed chromatosis (a reactive change that occurs in the cell body of damaged neurons) of ganglion cells. Accumulations of phagocytes (white blood cells) filled with fat or blood pigment occurred, and mucicarmine revealed a few drops of mucine in large round cells. THERE WAS FAILURE OF NERVE CELLS IN THE CORRESPONDING GANGLION, with prolefartion (growth) of fibroblasts and formation of connective tissue scars. (fibroblasts: cells that produce collagen fibers, these are non-stretchy fibers that ensure firmness of our tissues. In addition, they also create other components of the soil substance, or extracellular matrix, in the connective tissue). AGAIN, YOU CANNOT TALK ABOUT CLINNICALLY NOT RELEVANT, GIVEN TARLOV'S REACTION, DEGENERATIVE AND NERVE CEL DEATH, AND NECESSARY FURTHER STUDIES.

7/25/21 by SOSNL 2500

In 1938 publiceerde Isadore Max Tarlov, neurochirurg uit Connecticut, voor het eerst over deze Tarlov cysten (Tc’s) nadat hij deze ontdekte in een studie op menselijke kadavers. Zijn eerste bevindingen waren, dat dit “banale bevindingen” waren. In opvolgende studies kwam Tarlov met de conclusie dat deze cysten het "ischiassyndroom" kon veroorzaken. De “goedaardige bevindingen” werden vanaf toen beschreven als een bron van radiculaire pijn. Ook de Nederlandse prof. G. Padberg, zenuwarts te Maastricht, schreef reeds op 10 oktober 1959 in het Ned. T. Geneeskunde103. II. 41, over “Perineurale Wortelkystes” waarvan hij toen al argumenteerde dat het door artsen over het algemeen onvoldoende bekend was dat deze lage rugpijn, ischalgieën en neurologische stoornissen kunnen veroorzaken. https://sosnl.nl/medici/flyer-sosnl-nl

7/26/21 by Founder SOSNL 2500

Tarlov or perineurial cysts are lesions of the nerve root most often found in the sacral region. They were first discovered serendipitously by Tarlov in 1938 during his autopsy studies of the filum terminale at the Montreal Neurological Institute.37 Since his seminal report, more than 100 cases of symptomatic Tarlov cysts have been published in the literature.* The advent of computed tomography (CT) and magnetic resonance imaging (MRI) has enhanced our ability to recognize them as a cause of sacral neurologic dysfunction.

7/27/21 by KetoGma 2500

They were discover in corps / autopsy by a doctor named Isidore tarlov

10/25/22 by Tania 2500

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