scholarly journals A Rare Case of Tibial Intraneural Ganglion Cyst Arising From the Tibiofibular Joint

Cureus ◽  
2021 ◽  
Author(s):  
Savannah L Mayer ◽  
Jagmeet S Grewal ◽  
Tyler Gloe ◽  
Catherine A Khasho ◽  
Steven Harder
Keyword(s):  
Rare Case ◽  
Ganglion Cyst ◽  
Intraneural Ganglion ◽  
Intraneural Ganglion Cyst ◽  
Tibiofibular Joint

Unilateral hypoglossal nerve palsy caused by an intraneural ganglion cyst

2010 ◽  
Vol 113 (2) ◽  
pp. 380-383 ◽  
Author(s):  
Yoichi Nonaka ◽  
Peter M. Grossi ◽  
Carol A. Filomena ◽  
Allan H. Friedman ◽  
Takanori Fukushima
Keyword(s):  
Rare Case ◽  
Nerve Palsy ◽  
Hypoglossal Nerve ◽  
Ganglion Cyst ◽  
Intraneural Ganglion ◽  
Intraneural Ganglion Cyst ◽  
Hypoglossal Nerve Palsy ◽  
Pathological Classification ◽  
Atlantooccipital Joint ◽  
Synovial Cysts

The authors describe a rare case of unilateral hypoglossal nerve palsy caused by an intraneural ganglion cyst. Three similar cases have been reported with pathological classification still under consideration. One case was classified as an intraneural ganglion cyst and 2 cases were classified as atlantooccipital joint synovial cysts.

Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory

2007 ◽  
Vol 107 (2) ◽  
pp. 296-307 ◽  
Author(s):  
Robert J. Spinner ◽  
Kimberly K. Amrami ◽  
Alexandra P. Wolanskyj ◽  
Nicholas M. Desy ◽  
Huan Wang ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Ganglion Cyst ◽  
Cyst Formation ◽  
Intraneural Ganglion ◽  
Intraneural Ganglion Cyst ◽  
Articular Branch ◽  
Superior Tibiofibular Joint ◽  
Tibiofibular Joint ◽  
Joint Connection ◽  
Articular Theory

Object The pathogenesis of intraneural ganglia has been a controversial issue for longer than a century. Recently the authors identified a stereotypical pattern of occurrence of peroneal and tibial intraneural ganglia, and based on an understanding of their pathogenesis provided a unifying articular explanation. Atypical features, which occasionally are observed, have offered an opportunity to verify further and expand on the authors' proposed theory. Methods Three unusual cases are presented to exemplify the dynamic features of peroneal and tibial intraneural ganglia formation. Results Two patients with a predominant deep peroneal nerve deficit shared essential anatomical findings common to peroneal intraneural ganglia: namely, 1) joint connections to the anterior portion of the superior tibiofibular joint, and 2) dissection of the cyst along the articular branch of the peroneal nerve and proximally. Magnetic resonance (MR) images obtained in these patients demonstrated some unusual findings, including the presence of a cyst within the tibial and sural nerves in the popliteal fossa region, and spontaneous regression of the cysts, which was observed on serial images obtained weeks apart. The authors identified a clinical outlier, a case that could not be understood within the context of their previously reported theory of intraneural ganglion cyst formation. Described 32 years ago, this patient had a tibial neuropathy and was found at surgery to have tibial, peroneal, and sciatic intraneural cysts without a joint connection. The authors' hypothesis about this case, based on their unified theory, was twofold: 1) the lesion was a primary tibial intraneural ganglion with proximal extension followed by sciatic cross-over and distal descent; and 2) a joint connection to the posterior aspect of the superior tibiofibular joint with a remnant cyst within the articular branch would be present, a finding that would help explain the formation of different cysts by a single mechanism. The authors proved their hypothesis by careful inspection of a recently obtained postoperative MR image. Conclusions These three cases together with data obtained from a retrospective review of the authors' clinical material and findings reported in the literature provide firm evidence for mechanisms underlying intraneural ganglia formation. Thus, expansion of the authors' unified articular theory permits understanding and elucidation of unusual presentations of intraneural cysts. Whereas an articular connection and fluid following the path of least resistance was pivotal, the authors now incorporate dynamic aspects of cyst formation due to pressure fluxes. These basic principles explain patterns of ascent, cross-over, and descent down terminal nerve branches based on articular connections, paths of diminished resistance to fluid flow within recognized anatomical compartments, and the effects of fluctuating pressure gradients.

Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory

2007 ◽  
Vol 22 (6) ◽  
pp. 1-12
Author(s):  
Robert J. Spinner ◽  
Kimberly K. Amrami ◽  
Alexandra P. Wolanskyj ◽  
Nicholas M. Desy ◽  
Huan Wang ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Ganglion Cyst ◽  
Cyst Formation ◽  
Intraneural Ganglion ◽  
Intraneural Ganglion Cyst ◽  
Articular Branch ◽  
Superior Tibiofibular Joint ◽  
Tibiofibular Joint ◽  
Joint Connection ◽  
Articular Theory

Object The pathogenesis of intraneural ganglia has been a controversial issue for longer than a century. Recently the authors identified a stereotypical pattern of occurrence of peroneal and tibial intraneural ganglia, and based on an understanding of their pathogenesis provided a unifying articular explanation. Atypical features, which occasionally are observed, have offered an opportunity to verify further and expand on the authors' proposed theory. Methods Three unusual cases are presented to exemplify the dynamic features of peroneal and tibial intraneural ganglia formation. Results Two patients with a predominant deep peroneal nerve deficit shared essential anatomical findings common to peroneal intraneural ganglia: namely, 1) joint connections to the anterior portion of the superior tibiofibular joint, and 2) dissection of the cyst along the articular branch of the peroneal nerve and proximally. Magnetic resonance (MR) images obtained in these patients demonstrated some unusual findings, including the presence of a cyst within the tibial and sural nerves in the popliteal fossa region, and spontaneous regression of the cysts, which was observed on serial images obtained weeks apart. The authors identified a clinical outlier, a case that could not be understood within the context of their previously reported theory of intraneural ganglion cyst formation. Described 32 years ago, this patient had a tibial neuropathy and was found at surgery to have tibial, peroneal, and sciatic intraneural cysts without a joint connection. The authors' hypothesis about this case, based on their unified theory, was twofold: 1) the lesion was a primary tibial intraneural ganglion with proximal extension followed by sciatic cross-over and distal descent; and 2) a joint connection to the posterior aspect of the superior tibiofibular joint with a remnant cyst within the articular branch would be present, a finding that would help explain the formation of different cysts by a single mechanism. The authors proved their hypothesis by careful inspection of a recently obtained postoperative MR image. Conclusions These three cases together with data obtained from a retrospective review of the authors' clinical material and findings reported in the literature provide firm evidence for mechanisms underlying intraneural ganglia formation. Thus, expansion of the authors' unified articular theory permits understanding and elucidation of unusual presentations of intraneural cysts. Whereas an articular connection and fluid following the path of least resistance was pivotal, the authors now incorporate dynamic aspects of cyst formation due to pressure fluxes. These basic principles explain patterns of ascent, cross-over, and descent down terminal nerve branches based on articular connections, paths of diminished resistance to fluid flow within recognized anatomical compartments, and the effects of fluctuating pressure gradients.

Recurrent intraneural ganglion cyst of the tibial nerve

2000 ◽  
Vol 92 (2) ◽  
pp. 334-337 ◽  
Author(s):  
Robert J. Spinner ◽  
John L. D. Atkinson ◽  
C. Michel Harper ◽  
Doris E. Wenger
Keyword(s):  
Tibial Nerve ◽  
Ganglion Cyst ◽  
Symptomatic Relief ◽  
Proximal Tibiofibular Joint ◽  
Cell Of Origin ◽  
Intraneural Ganglion ◽  
Intraneural Ganglion Cyst ◽  
Content Type ◽  
Ganglion Cysts ◽  
Tibiofibular Joint

✓ Different theories have evolved to explain the pathogenesis and the cell of origin of intraneural ganglion cysts. Reportedly only three cases of intraneural ganglion of the tibial nerve have been located within the popliteal fossa, and all of these were thought to arise within the nerve. The authors report a case of a recurrent tibial intraneural ganglion in which a connection to the proximal tibiofibular joint was demonstrated on magnetic resonance (MR) images and at surgery. Surgical ligation of the articular branch and evacuation of the cyst led to symptomatic relief, and an MR image obtained 1 year after surgery documented no recurrence. This case reinforces the fact that surgeons need to consider and search for an articular connection in all cases of intraneural ganglia, especially in those that have recurred.

Cystic degeneration of the tibial nerve: magnetic resonance neurography and sonography appearances of an intraneural ganglion cyst

2017 ◽  
Vol 46 (12) ◽  
pp. 1763-1767 ◽  
Author(s):  
Cláudio Régis Sampaio Silveira ◽  
Clarissa Gadelha Maia Vieira ◽  
Brenda Machado Pereira ◽  
Luiz Holanda Pinto Neto ◽  
Avneesh Chhabra
Keyword(s):  
Magnetic Resonance ◽  
Tibial Nerve ◽  
Ganglion Cyst ◽  
Cystic Degeneration ◽  
Intraneural Ganglion ◽  
Intraneural Ganglion Cyst ◽  
Magnetic Resonance Neurography
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