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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

Axial T1, T2-weighted MRI (left, center), sagittal T2-weighted MRI (right). The focal mildly high T2 intensity in the cord (arrows) was believed to be due to regional edema, gliosis or postoperative effects.
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Figure 0004: Axial T1, T2-weighted MRI (left, center), sagittal T2-weighted MRI (right). The focal mildly high T2 intensity in the cord (arrows) was believed to be due to regional edema, gliosis or postoperative effects.

Mentions: By 2 postoperative weeks, the patient had recovered muscle power and some sensation, with a slight lessening of spasticity. A half year later, the spinal cord remained reduced on postoperative MRI (Figure 4). Atrophy and high signal changes within the spinal cord were not observed. At 2 years follow up, the patient had no recurrence of symptoms, no instability and no back pain.


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)

Axial T1, T2-weighted MRI (left, center), sagittal T2-weighted MRI (right). The focal mildly high T2 intensity in the cord (arrows) was believed to be due to regional edema, gliosis or postoperative effects.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0004: Axial T1, T2-weighted MRI (left, center), sagittal T2-weighted MRI (right). The focal mildly high T2 intensity in the cord (arrows) was believed to be due to regional edema, gliosis or postoperative effects.
Mentions: By 2 postoperative weeks, the patient had recovered muscle power and some sensation, with a slight lessening of spasticity. A half year later, the spinal cord remained reduced on postoperative MRI (Figure 4). Atrophy and high signal changes within the spinal cord were not observed. At 2 years follow up, the patient had no recurrence of symptoms, no instability and no back pain.

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