{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T09:01:06Z","timestamp":1780736466525,"version":"3.54.1"},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The authors have observed that a subset of patients referred for evaluation of peroneal neuropathy with \u201cnegative\u201d findings on MRI of the knee have subtle evidence of a peroneal intraneural ganglion cyst on subsequent closer inspection. The objective of this study was to introduce the nearly invisible peroneal intraneural ganglion cyst and provide illustrative cases. The authors further wanted to identify clues to the presence of a nearly invisible cyst.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Illustrative cases demonstrating nearly invisible peroneal intraneural ganglion cysts were retrospectively reviewed and are presented. Case history and physical examination, imaging, and intraoperative findings were reviewed for each case. The outcomes of interest were the size and configuration of peroneal intraneural ganglion cysts over time, relative to various interventions that were performed, and in relation to physical examination and electrodiagnostic findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The authors present a series of cases that highlight the dynamic nature of peroneal intraneural ganglion cysts and introduce the nearly invisible cyst as a new and emerging part of the spectrum. The cases demonstrate changes in size and morphology over time of both the intraneural and extraneural compartments of these cysts. Despite \u201cnegative\u201d MR imaging findings, nearly invisible cysts can be identified in a subset of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The authors demonstrate here that peroneal intraneural ganglion cysts ride a roller coaster of change in both size and morphology over time, and they describe the nearly invisible cyst as one end of the spectrum. They identified clues to the presence of a nearly invisible cyst, including deep peroneal predominant symptoms, fluctuating symptoms, denervation changes in the tibialis anterior muscle, and abnormalities of the superior tibiofibular joint, and they correlate the subtle imaging findings to the internal fascicular topography of the common peroneal nerve. The description of the nearly invisible cyst may allow for increased recognition of this pathological entity that occurs with a spectrum of findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2016.12.focus16439","type":"journal-article","created":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T03:44:22Z","timestamp":1488339862000},"page":"E10","source":"Crossref","is-referenced-by-count":24,"title":["The nearly invisible intraneural cyst: a new and emerging part of the spectrum"],"prefix":"10.3171","volume":"42","author":[{"given":"Thomas J.","family":"Wilson","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-No\u00eblle","family":"H\u00e9bert-Blouin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen S.","family":"Murthy","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaqu\u00edn J.","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly K.","family":"Amrami","sequence":"additional","affiliation":[{"name":"Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Spinner","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus16439","series-title":"J Neurosurg","first-page":"615","article-title":"Intraneural ganglion cysts: a systematic review and reinterpretation of the world's literature","volume":"125","author":"Desy NM,","year":"2016","unstructured":"Desy NM, Wang H, Elshiekh MA, Tanaka S, Choi TW, Howe BM, : Intraneural ganglion cysts: a systematic review and reinterpretation of the world's literature. J Neurosurg 125:615\u2013630, 2016"},{"key":"b2-focus16439","series-title":"J Rehabil Res Dev","first-page":"309","article-title":"Human distal sciatic nerve fascicular anatomy: implications for ankle control using nerve-cuff electrodes","volume":"49","author":"Gustafson KJ,","year":"2012","unstructured":"Gustafson KJ, Grinberg Y, Joseph S, Triolo RJ: Human distal sciatic nerve fascicular anatomy: implications for ankle control using nerve-cuff electrodes. J Rehabil Res Dev 49:309\u2013321, 2012"},{"key":"b3-focus16439","series-title":"Acta Neurochir (Wien)","first-page":"837","article-title":"Peroneal intraneural ganglion cysts at the fibular neck: the layered \u201cU\u201d surgical approach to the articular branch and superior tibiofibular joint","volume":"157","author":"Lipinski LJ,","year":"2015","unstructured":"Lipinski LJ, Rock MG, Spinner RJ: Peroneal intraneural ganglion cysts at the fibular neck: the layered \u201cU\u201d surgical approach to the articular branch and superior tibiofibular joint. Acta Neurochir (Wien) 157:837\u2013840, 2015"},{"key":"b4-focus16439","series-title":"J Foot Ankle Surg","first-page":"78","article-title":"Occult isolated articular branch cyst of the lateral plantar nerve","volume":"56","author":"Prasad N,","year":"2017","unstructured":"Prasad N, Amrami KK, Yangi K, Spinner RJ: Occult isolated articular branch cyst of the lateral plantar nerve. J Foot Ankle Surg 56:78\u201381, 2017"},{"key":"b5-focus16439","series-title":"Clin Anat","first-page":"1128","article-title":"Direct superior tibiofibular joint arthrography demonstrates consistent communication with the tibiofemoral joint","volume":"27","author":"Puffer RC,","year":"2014","unstructured":"Puffer RC, Spinner RJ, Amrami KK, Skinner JA: Direct superior tibiofibular joint arthrography demonstrates consistent communication with the tibiofemoral joint. Clin Anat 27:1128\u20131129, 2014"},{"key":"b6-focus16439","series-title":"Clin Anat","first-page":"253","article-title":"CT and MR arthrograms demonstrate a consistent communication between the tibiofemoral and superior tibiofibular joints","volume":"26","author":"Puffer RC,","year":"2013","unstructured":"Puffer RC, Spinner RJ, Murthy NS, Amrami KK: CT and MR arthrograms demonstrate a consistent communication between the tibiofemoral and superior tibiofibular joints. 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Skeletal Radiol 37:79\u201384, 2008"},{"key":"b17-focus16439","series-title":"J Hand Surg Am","first-page":"e223","article-title":"The unifying articular (synovial) origin for intraneural ganglion cysts: moving beyond a theory.","volume":"41","author":"Spinner RJ,","year":"2016","unstructured":"Spinner RJ, Desy NM, Amrami KK: The unifying articular (synovial) origin for intraneural ganglion cysts: moving beyond a theory.. J Hand Surg Am 41:e223\u2013e224, 2016"},{"key":"b18-focus16439","series-title":"J Neurosurg","first-page":"217","article-title":"Extreme intraneural ganglion cysts","volume":"114","author":"Spinner RJ,","year":"2011","unstructured":"Spinner RJ, H\u00e9bert-Blouin MN, Rock MG, Amrami KK: Extreme intraneural ganglion cysts. 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J Neurosurg 125:615\u2013630, 2016"},{"key":"b2-focus16439","series-title":"J Rehabil Res Dev","first-page":"309","article-title":"Human distal sciatic nerve fascicular anatomy: implications for ankle control using nerve-cuff electrodes","volume":"49","author":"Gustafson KJ,","year":"2012","unstructured":"Gustafson KJ, Grinberg Y, Joseph S, Triolo RJ: Human distal sciatic nerve fascicular anatomy: implications for ankle control using nerve-cuff electrodes. J Rehabil Res Dev 49:309\u2013321, 2012"},{"key":"b3-focus16439","series-title":"Acta Neurochir (Wien)","first-page":"837","article-title":"Peroneal intraneural ganglion cysts at the fibular neck: the layered \u201cU\u201d surgical approach to the articular branch and superior tibiofibular joint","volume":"157","author":"Lipinski LJ,","year":"2015","unstructured":"Lipinski LJ, Rock MG, Spinner RJ: Peroneal intraneural ganglion cysts at the fibular neck: the layered \u201cU\u201d surgical approach to the articular branch and superior tibiofibular joint. Acta Neurochir (Wien) 157:837\u2013840, 2015"},{"key":"b4-focus16439","series-title":"J Foot Ankle Surg","first-page":"78","article-title":"Occult isolated articular branch cyst of the lateral plantar nerve","volume":"56","author":"Prasad N,","year":"2017","unstructured":"Prasad N, Amrami KK, Yangi K, Spinner RJ: Occult isolated articular branch cyst of the lateral plantar nerve. J Foot Ankle Surg 56:78\u201381, 2017"},{"key":"b5-focus16439","series-title":"Clin Anat","first-page":"1128","article-title":"Direct superior tibiofibular joint arthrography demonstrates consistent communication with the tibiofemoral joint","volume":"27","author":"Puffer RC,","year":"2014","unstructured":"Puffer RC, Spinner RJ, Amrami KK, Skinner JA: Direct superior tibiofibular joint arthrography demonstrates consistent communication with the tibiofemoral joint. Clin Anat 27:1128\u20131129, 2014"},{"key":"b6-focus16439","series-title":"Clin Anat","first-page":"253","article-title":"CT and MR arthrograms demonstrate a consistent communication between the tibiofemoral and superior tibiofibular joints","volume":"26","author":"Puffer RC,","year":"2013","unstructured":"Puffer RC, Spinner RJ, Murthy NS, Amrami KK: CT and MR arthrograms demonstrate a consistent communication between the tibiofemoral and superior tibiofibular joints. 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J Surg Orthop Adv 20:136\u2013141, 2011"},{"key":"b9-focus16439","series-title":"J Hand Surg Am","first-page":"1698","article-title":"Intraneural ganglion of the suprascapular nerve: case report","volume":"31","author":"Spinner RJ,","year":"2006","unstructured":"Spinner RJ, Amrami KK: Intraneural ganglion of the suprascapular nerve: case report. J Hand Surg Am 31:1698\u20131699, 2006"},{"issue":"6","key":"b10-focus16439","series-title":"Neurosurg Focus","first-page":"E17","article-title":"Peroneal and tibial intraneural ganglia: correlation between intraepineurial compartments observed on magnetic resonance images and the potential importance of these compartments","volume":"22","author":"Spinner RJ,","year":"2007","unstructured":"Spinner RJ, Amrami KK, Angius D, Wang H, Carmichael SW: Peroneal and tibial intraneural ganglia: correlation between intraepineurial compartments observed on magnetic resonance images and the potential importance of these compartments.  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Skeletal Radiol 35:172\u2013179, 2006"},{"key":"b13-focus16439","series-title":"J Neurosurg","first-page":"296","article-title":"Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory","volume":"107","author":"Spinner RJ,","year":"2007","unstructured":"Spinner RJ, Amrami KK, Wolanskyj AP, Desy NM, Wang H, Benarroch EE, : Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory. J Neurosurg 107:296\u2013307, 2007"},{"key":"b14-focus16439","series-title":"J Neurosurg","first-page":"319","article-title":"Peroneal intraneural ganglia: the importance of the articular branch. Clinical series","volume":"99","author":"Spinner RJ,","year":"2003","unstructured":"Spinner RJ, Atkinson JL, Scheithauer BW, Rock MG, Birch R, Kim TA, : Peroneal intraneural ganglia: the importance of the articular branch. Clinical series. 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J Neurosurg 114:217\u2013224, 2011"},{"key":"b19-focus16439","series-title":"Acta Neurochir (Wien)","first-page":"919","article-title":"Knee MR arthrographic proof of an articular origin for combined intraneural and adventitial cysts","volume":"152","author":"Spinner RJ,","year":"2010","unstructured":"Spinner RJ, H\u00e9bert-Blouin MN, Skinner JA, Amrami KK: Knee MR arthrographic proof of an articular origin for combined intraneural and adventitial cysts. Acta Neurochir (Wien) 152:919\u2013923, 2010"},{"key":"b20-focus16439","series-title":"Skeletal Radiol","first-page":"1091","article-title":"The clock face guide to peroneal intraneural ganglia: critical \u201ctimes\u201d and sites for accurate diagnosis","volume":"37","author":"Spinner RJ,","year":"2008","unstructured":"Spinner RJ, Luthra G, Desy NM, Anderson ML, Amrami KK: The clock face guide to peroneal intraneural ganglia: critical \u201ctimes\u201d and sites for accurate diagnosis. 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