Intraneural Ganglion as the Cause of Compression-Ischemic Lesion of Peroneal Nerve in Children

The etiology of intraneural ganglion cysts has been poorly understood. This has resulted in the development of multiple surgical treatment strategies and a high recurrence rate. We sought to analyze these recurrences in order to provide a pathoanatomic explanation and staging classification for intraneural cyst recurrence. An expanded literature search was performed to identify frequencies and patterns in cases of intraneural ganglion cyst recurrences following primary surgery. Two univariate analyses were completed to identify associations between the type of revision surgery and repeat cyst recurrences. The expanded literature search found an 11% recurrence rate following primary surgery, including 64 recurrences following isolated cyst decompression (Group 1); six after articular branch resection (Group 2); and none following surgical procedures that addressed the joint (Group 3). Eight cases did not specify the type of primary surgery. In group 1, forty-eight of the recurrences (75%) were in the parent nerve, three involved only the articular branch, and one travelled along the articular branch in a different distal direction without involving the main parent nerve. In group 2, only one case (17%) recurred/persisted within the parent nerve, one recurred within a persistent articular branch, and one formed within a persistent articular branch and travelled in a different distal direction. Intraneural recurrences most commonly occur following surgical procedures that only target the main parent nerve. We provide proven or theoretical explanations for all identified cases of intraneural recurrences for an occult or persistent articular branch pathway.

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Recurrent intraneural ganglion cysts: Pathoanatomic patterns and treatment implications

Desy

Lipinski

Tanaka

et al. 2015

Clinical Anatomy

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Intraneural synovial cyst of the peroneal nerve: literature review and description of a clinical case

Kenis

Parshin

Sapogovskiy

2022

Nevrol. ž. im. L.O. Badalâna

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Introduction. Intraneural synovial cyst is a rare pathological condition, which can be symptomatic due to the compression of the neighboring structures, including the peroneal nerve. The purpose of this publication is to present a clinical case of intraneural ganglion of the peroneal nerve with a critical analysis of diagnostic and tactical errors in diagnosis and treatment tactics, and literature review. We present a clinical case of a patient with an intraneural cyst of the peroneal nerve, who had 3 surgical interventions over a period of 1.5 years from the age of 13 years, followed by recurrences without restoration of muscle function. The case demonstrates underestimation of the pathogenesis of the described condition - the presence of a communicant nerve between the proximal tibiofibular joint and the peroneal nerve and proximal tibiofemoral joint as the source of synovial effusion. Awareness in relation to this pathology will improve the efficiency of diagnosis. Interdisciplinary approach of pediatric neurologists, orthopedists, neurophysiologists and radiologists can shorten the diagnostic stage and enable the earliest and most effective surgical treatment to avoid irreversible consequences due to prolonged muscle denervation.

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Intraneural Ganglion as the Cause of Compression-Ischemic Lesion of Peroneal Nerve in Children

Cited by 2 publications

References 9 publications

Recurrent intraneural ganglion cysts: Pathoanatomic patterns and treatment implications

Recurrent intraneural ganglion cysts: Pathoanatomic patterns and treatment implications

Intraneural synovial cyst of the peroneal nerve: literature review and description of a clinical case

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