Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Idiopathic Spinal Cord Herniation Presented as Brown-Sequard Syndrome : A Case Report and Surgical Outcome

  • Ju, Min-Wook (Department of Neurosurgery, Chungnam National University Hospital) ;
  • Choi, Seung-Won (Department of Neurosurgery, Chungnam National University Hospital) ;
  • Youm, Jin-Young (Department of Neurosurgery, Chungnam National University Hospital) ;
  • Kwon, Hyon-Jo (Department of Neurosurgery, Chungnam National University Hospital)
  • Received : 2015.03.08
  • Accepted : 2015.08.04
  • Published : 2015.10.28
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Abstract

Spinal cord herniation is a rare condition that has become increasingly recognised in the last few years. The authors report a case of idiopathic spinal cord herniation in a 33 year old woman performed with progressive Brown-Sequard syndrome. The diagnosis was made on MR imaging. After repairing the herniation, the patient made a gradual improvement. Potential causes are discussed, including a possible role of dural defect. In conclusion, idiopathic spinal cord herniation is a potentially treatable condition that should be more readily diagnosed that increasing awareness and improved imaging techniques.

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References

  1. Abe M, Komori H, Yamaura I, Kayano T : Spinal cord herniation into an extensive extradural meningeal cyst : postoperative analysis of intracystic flow by phase-contrast cine MRI. J Orthop Sci 4 : 450-456, 1999 https://doi.org/10.1007/s007760050129
  2. Aizawa T, Sato T, Tanaka Y, Kotajima S, Sekiya M, Kokubun S : Idiopathic herniation of the thoracic spinal cord : report of three cases. Spine (Phila Pa 1976) 26 : E488-E491, 2001 https://doi.org/10.1097/00007632-200110150-00030
  3. Barbagallo GM, Marshman LA, Hardwidge C, Gullan RW : Thoracic idiopathic spinal cord herniation at the vertebral body level : a subgroup with a poor prognosis? Case reports and review of the literature. J Neurosurg 97 (3 Suppl) : 369-374, 2002
  4. Borges LF, Zervas NT, Lehrich JR : Idiopathic spinal cord herniation : a treatable cause of the Brown-Sequard syndrome--case report. Neurosurgery 36 : 1028-1032; discussion 1032-1033, 1995 https://doi.org/10.1227/00006123-199505000-00023
  5. Brugieres P, Malapert D, Adle-Biassette H, Fuerxer F, Djindjian M, Gaston A : Idiopathic spinal cord herniation: value of MR phase-contrast imaging. AJNR Am J Neuroradiol 20 : 935-939, 1999
  6. Ellger T, Schul C, Heindel W, Evers S, Ringelstein EB : Idiopathic spinal cord herniation causing progressive Brown-Sequard syndrome. Clin Neurol Neurosurg 108 : 388-391, 2006 https://doi.org/10.1016/j.clineuro.2004.07.005
  7. Ewald C, Kuhne D, Hassler WE : Progressive spontaneous herniation of the thoracic spinal cord : case report. Neurosurgery 46 : 493-495; discussion 495-496, 2000 https://doi.org/10.1097/00006123-200002000-00046
  8. Gandhi D, Goyal M, Bourque PR : Case 138 : Idiopathic spinal cord herniation. Radiology 249 : 384-388, 2008 https://doi.org/10.1148/radiol.2491020676
  9. Ghostine S, Baron EM, Perri B, Jacobson P, Morsette D, Hsu FP : Thoracic cord herniation through a dural defect : description of a case and review of the literature. Surg Neurol 71 : 362-366, discussion 366-367, 2009 https://doi.org/10.1016/j.surneu.2007.08.022
  10. Haber MD, Nguyen DD, Li S : Differentiation of idiopathic spinal cord herniation from CSF-isointense intraspinal extramedullary lesions displacing the cord. Radiographics 34 : 313-329, 2014 https://doi.org/10.1148/rg.342125136
  11. Heo SH, Kim JH, Ahn TB, Kim EJ, Park KC, Yoon SS, et al. : A case sug gesting spontaneous spinal cord herniation presented as brown-sequard syndrome. J Korean Neurol Assoc 25 : 133-135, 2007
  12. Isu T, Iizuka T, Iwasaki Y, Nagashima M, Akino M, Abe H : Spinal cord herniation associated with an intradural spinal arachnoid cyst diagnosed by magnetic resonance imaging. Neurosurgery 29 : 137-139, 1991 https://doi.org/10.1227/00006123-199107000-00027
  13. Iyer RV, Coutinho C, Lye RH : Spontaneous spinal cord herniation. Br J Neurosurg 16 : 507-510, 2002 https://doi.org/10.1080/0268869021000030960
  14. Jin SC, Lee SR, Park DW, Joo KB : Spontaneous herniation of the thoracic spinal cord : a case report. J Korean Radiol Soc 45 : 353-355, 2001 https://doi.org/10.3348/jkrs.2001.45.4.353
  15. Joseph T, Adeosun A, Paes T, Bahal V : Randomised controlled trial to evaluate the efficacy of TachoComb H patches in controlling PTFE suture-hole bleeding. Eur J Vasc Endovasc Surg 27 : 549-552, 2004 https://doi.org/10.1016/j.ejvs.2004.01.018
  16. Kim JM, Oh SH, Kim KJ, Park SH, Park KS : Idiopathic spinal cord herniation as a treatable cause of progressive brown-sequard syndrome. J Clin Neurol 3 : 204-207, 2007 https://doi.org/10.3988/jcn.2007.3.4.204
  17. Lang G, Csekeo A, Stamatis G, Lampl L, Hagman L, Marta GM, et al. : Efficacy and safety of topical application of human fibrinogen/thrombin-coated collagen patch (TachoComb) for treatment of air leakage after standard lobectomy. Eur J Cardiothorac Surg 25 : 160-166, 2004 https://doi.org/10.1016/j.ejcts.2003.11.018
  18. Massicotte EM, Montanera W, Ross Fleming JF, Tucker WS, Willinsky R, TerBrugge K, et al. : Idiopathic spinal cord herniation : report of eight cases and review of the literature. Spine (Phila Pa 1976) 27 : E233-E241, 2002 https://doi.org/10.1097/00007632-200205010-00025
  19. Matsumura T, Takahashi MP, Nozaki S, Kang J : [A case of idiopathic spinal cord herniation]. Rinsho Shinkeigaku 36 : 566-570, 1996
  20. Miyaguchi M, Nakamura H, Shakudo M, Inoue Y, Yamano Y : Idiopathic spinal cord herniation associated with intervertebral disc extrusion : a case report and review of the literature. Spine (Phila Pa 1976) 26 : 1090-1094, 2001 https://doi.org/10.1097/00007632-200105010-00022
  21. Miyake S, Tamaki N, Nagashima T, Kurata H, Eguchi T, Kimura H : Idiopathic spinal cord herniation. Report of two cases and review of the literature. J Neurosurg 88 : 331-335, 1998 https://doi.org/10.3171/jns.1998.88.2.0331
  22. Mokri B : Spontaneous low cerebrospinal pressure/volume headaches. Curr Neurol Neurosci Rep 4 : 117-124, 2004 https://doi.org/10.1007/s11910-004-0025-5
  23. Muto A, Nishibe T, Kondo Y, Sato M, Yamashita M, Ando M : Sutureless repair with TachoComb sheets for oozing type postinfarction cardiac rupture. Ann Thorac Surg 79 : 2143-2145, 2005 https://doi.org/10.1016/j.athoracsur.2003.12.033
  24. Najjar MW, Baeesa SS, Lingawi SS : Idiopathic spinal cord herniation : a new theory of pathogenesis. Surg Neurol 62 : 161-170; discussion 170-171, 2004 https://doi.org/10.1016/j.surneu.2003.10.030
  25. Novak K, Widhalm G, de Camargo AB, Perin N, Jallo G, Knosp E, et al. : The value of intraoperative motor evoked potential monitoring during surgical intervention for thoracic idiopathic spinal cord herniation. J Neurosurg Spine 16 : 114-126, 2012 https://doi.org/10.3171/2011.10.SPINE11109
  26. Parmar H, Park P, Brahma B, Gandhi D : Imaging of idiopathic spinal cord herniation. Radiographics 28 : 511-518, 2008 https://doi.org/10.1148/rg.282075030
  27. Sagiuchi T, Iida H, Tachibana S, Utsuki S, Tanaka R, Fujii K : Idiopathic spinal cord herniation associated with calcified thoracic disc extrusion--case report. Neurol Med Chir (Tokyo) 43 : 364-368, 2003 https://doi.org/10.2176/nmc.43.364
  28. Salvador Alvarez E, Jimenez De La Pena M, Herraiz Hidalgo L, Pardo Moreno J : [Idiopathic spinal cord herniation : a rare condition]. Radiologia 52 : 353-356, 2010 https://doi.org/10.1016/j.rx.2010.01.018
  29. Sasani M, Ozer AF, Vural M, Sarioglu AC : Idiopathic spinal cord herniation : case report and review of the literature. J Spinal Cord Med 32 : 86-94, 2009 https://doi.org/10.1080/10790268.2009.11760757
  30. Sioutos P, Arbit E, Tsairis P, Gargan R : Spontaneous thoracic spinal cord herniation. A case report. Spine (Phila Pa 1976) 21 : 1710-1713, 1996 https://doi.org/10.1097/00007632-199607150-00019
  31. Summers JC, Balasubramani YV, Chan PC, Rosenfeld JV : Idiopathic spinal cord herniation : clinical review and report of three cases. Asian J Neurosurg 8 : 97-105, 2013 https://doi.org/10.4103/1793-5482.116386
  32. Tekkok IH : Spontaneous spinal cord herniation : case report and review of the literature. Neurosurgery 46 : 485-491; discussion 491-492, 2000 https://doi.org/10.1097/00006123-200002000-00044
  33. Urbach H, Kaden B, Pechstein U, Solymosi L : Herniation of the spinal cord 38 years after childhood trauma. Neuroradiology 38 : 157-158, 1996 https://doi.org/10.1007/BF00604806
  34. Wada E, Yonenobu K, Kang J : Idiopathic spinal cord herniation : report of three cases and review of the literature. Spine (Phila Pa 1976) 25 : 1984-1988, 2000 https://doi.org/10.1097/00007632-200008010-00019
  35. Wortzman G, Tasker RR, Rewcastle NB, Richardson JC, Pearson FG : Spontaneous incarcerated herniation of the spinal cord into a vertebral body : a unique cause of paraplegia. Case report. J Neurosurg 41 : 631-635, 1974 https://doi.org/10.3171/jns.1974.41.5.0631