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Idiopathic spinal cord herniation with duplicated dura mater and dorsal subarachnoid septum. Report of a case and review of the literature.

Yamamoto N, Katoh S, Higashino K, Sairyo K - Int J Spine Surg (2014)

Bottom Line: Intraoperatively, the dorsal dura mater was seen to be adherent and the subarachnoid septum was identified after durotomy.The inner layer defect of the duplicated dura mater was found in the ventral dura mater, through which the spinal cord had herniated.After releasing the septum, the adhesions around the dura mater, and the hiatus, the spinal cord was reduced.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.

ABSTRACT

Background: Idiopathic spinal cord herniation (ISCH) is a rare condition and its pathogenesis remains unclear. The purpose of this case report is to present an ISCH case with dorsal subarachnoid septum suggesting the pathogenesis of ISCH being adhesions from preexisting inflammation.

Methods: Single case report.

Results: A 60-year-old woman presented with Brown-Séquard syndrome below the level of T6. Magnetic resonance imaging revealed the thoracic spinal cord was displaced ventrally, and the dorsal subarachnoid space was enlarged and had a septum between the spinal cord and dura mater. Intraoperatively, the dorsal dura mater was seen to be adherent and the subarachnoid septum was identified after durotomy. The inner layer defect of the duplicated dura mater was found in the ventral dura mater, through which the spinal cord had herniated. After releasing the septum, the adhesions around the dura mater, and the hiatus, the spinal cord was reduced.

Conclusions: The present case indicates that adhesions around the dura mater can be the pathogenesis of ISCH.

No MeSH data available.


Related in: MedlinePlus

Intraoperative photographs. The upper photograph shows the dorsal subarachnoid septum (arrows). Right side is cranial. The lower photograph indicates the vessels in the septum (arrows).
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Figure 0003: Intraoperative photographs. The upper photograph shows the dorsal subarachnoid septum (arrows). Right side is cranial. The lower photograph indicates the vessels in the septum (arrows).

Mentions: Laminectomy and right-sided partial pediculotomy of the T5 and T6 vertebrae was performed, and adhesion of the dura mater was found. Ultrasonography revealed the septum in the dorsal subarachnoid space, and a ventral spinal cord herniation and the dorsal subarachnoid septum were identified after durotomy. The septum was a muddy, thin, shiny whitish membrane containing small vessels, and was 15 mm in cephalocaudal length. It connected the dorsal dura mater to the dorsal surface of the spinal cord (Figure 3), it is not a normal arachnoid trabeculation which is usually seen in the thoracic spine. Cerebrospinal fluid (CSF) flowed freely around the septum.


Idiopathic spinal cord herniation with duplicated dura mater and dorsal subarachnoid septum. Report of a case and review of the literature.

Yamamoto N, Katoh S, Higashino K, Sairyo K - Int J Spine Surg (2014)

Intraoperative photographs. The upper photograph shows the dorsal subarachnoid septum (arrows). Right side is cranial. The lower photograph indicates the vessels in the septum (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325502&req=5

Figure 0003: Intraoperative photographs. The upper photograph shows the dorsal subarachnoid septum (arrows). Right side is cranial. The lower photograph indicates the vessels in the septum (arrows).
Mentions: Laminectomy and right-sided partial pediculotomy of the T5 and T6 vertebrae was performed, and adhesion of the dura mater was found. Ultrasonography revealed the septum in the dorsal subarachnoid space, and a ventral spinal cord herniation and the dorsal subarachnoid septum were identified after durotomy. The septum was a muddy, thin, shiny whitish membrane containing small vessels, and was 15 mm in cephalocaudal length. It connected the dorsal dura mater to the dorsal surface of the spinal cord (Figure 3), it is not a normal arachnoid trabeculation which is usually seen in the thoracic spine. Cerebrospinal fluid (CSF) flowed freely around the septum.

Bottom Line: Intraoperatively, the dorsal dura mater was seen to be adherent and the subarachnoid septum was identified after durotomy.The inner layer defect of the duplicated dura mater was found in the ventral dura mater, through which the spinal cord had herniated.After releasing the septum, the adhesions around the dura mater, and the hiatus, the spinal cord was reduced.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.

ABSTRACT

Background: Idiopathic spinal cord herniation (ISCH) is a rare condition and its pathogenesis remains unclear. The purpose of this case report is to present an ISCH case with dorsal subarachnoid septum suggesting the pathogenesis of ISCH being adhesions from preexisting inflammation.

Methods: Single case report.

Results: A 60-year-old woman presented with Brown-Séquard syndrome below the level of T6. Magnetic resonance imaging revealed the thoracic spinal cord was displaced ventrally, and the dorsal subarachnoid space was enlarged and had a septum between the spinal cord and dura mater. Intraoperatively, the dorsal dura mater was seen to be adherent and the subarachnoid septum was identified after durotomy. The inner layer defect of the duplicated dura mater was found in the ventral dura mater, through which the spinal cord had herniated. After releasing the septum, the adhesions around the dura mater, and the hiatus, the spinal cord was reduced.

Conclusions: The present case indicates that adhesions around the dura mater can be the pathogenesis of ISCH.

No MeSH data available.


Related in: MedlinePlus