Anaesthetic considerations for elective cesarean section in a patient with a giant Tarlov cyst.

Tarlov cysts are a pathological dilatation of the meninges. Their incidence is more frequent in women between 30 and 50 years of age. The imaging test of choice for diagnosis is MRI. Of unknown etiology, most cases are asymptomatic, but symptoms of radicular irritation, among others, may occur. The therapeutic possibilities are multiple, reserving surgical excision as the last option. We report a case of successful spinal anaesthesia for elective cesarean section in a patient with a giant Tarlov cyst but with potential airway compromise, in whom the risks of general anaesthesia would be increased. Anaesthetic management presents a challenge for the anesthesiologist, especially in situations where the patient presents an increased anaesthetic risk for general anaesthesia, as is the case in the obstetric patient.

Consideraciones anestésicas para cesárea electiva en una paciente con quiste de Tarlov gigante / Anaesthetic considerations for elective cesarean section in a patient with a giant Tarlov cyst

Los quistes de Tarlov son una dilatación patológica de las meninges. Su incidencia es más frecuente en mujeres de edades comprendidas entre 30 y 50 años. La prueba de imagen de elección para su diagnóstico es la RM. De etiología desconocida, la mayoría de los casos son asintomáticos, pero pueden manifestarse síntomas de irritación radicular, entre otros. Las posibilidades terapéuticas son múltiples, reservando la escisión quirúrgica como último escalón. Presentamos un caso en el que se realiza con éxito una anestesia raquídea para una cesárea electiva en una paciente con un quiste de Tarlov gigante, pero con potencial compromiso de la vía aérea, en la que la que los riesgos de una anestesia general podrían estar aumentados. El manejo anestésico presenta un desafío para el anestesiólogo, especialmente en situaciones en las que el paciente presente un riesgo anestésico aumentado para la anestesia general, como es el caso de la paciente obstétrica.(AU)

Tarlov cysts are a pathological dilatation of the meninges. Their incidence is more frequent in women between 30 and 50 years of age. The imaging test of choice for diagnosis is MRI. Of unknown etiology, most cases are asymptomatic, but symptoms of radicular irritation, among others, may occur. The therapeutic possibilities are multiple, reserving surgical excision as the last option. We report a case of successful spinal anaesthesia for elective cesarean section in a patient with a giant Tarlov cyst but with potential airway compromise, in whom the risks of general anaesthesia would be increased. Anaesthetic management presents a challenge for the anesthesiologist, especially in situations where the patient presents an increased anaesthetic risk for general anaesthesia, as is the case in the obstetric patient.(AU)

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