Acta neurochirurgica
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Acta neurochirurgica · Jan 2009
Case ReportsSciatic cross-over in patients with peroneal and tibial intraneural ganglia confirmed by knee MR arthrography.
A predictable mechanism and stereotypic patterns of peroneal intraneural ganglia are being defined based on careful analysis of MRIs. Peroneal and tibial intraneural ganglia extending from the superior tibiofibular joint which extend to the level of the sciatic nerve have been observed leading to the hypothesis that sciatic cross-over could exist. Such a cross-over phenomenon would allow intraneural cyst from the peroneal nerve by means of its shared epineurial sheath within the sciatic nerve to cross over to involve the tibial nerve, or vice versa from a tibial intraneural cyst to the peroneal nerve. ⋯ This study provides direct in vivo proof of the nature of sciatic cross-over theorized by critical review of MRIs and/or experimental dye injections done in cadavers. This study is important in clarifying the potential paths of propagation of intraneural cysts at points of major bifurcation.