Thoracic Spinal Cord Herniation presenting with Brown-Sequard Syndrome

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  • Brown-Sequard症候群を呈した胸髄脊髄ヘルニアの1例

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An increasing number of cases involving spinal cord herniation have been reported since the advent fo magnetic resonance imaging(MRI).A57-year-old woman with a history of previous blunt thoracic back trauma resulting from a traffic accident 9 years ago, presented with Brown-Sequard syndrome. MRI of the thoracic spine revealed ventral displacement of the spinal cord at Th4/5 and a dorsal intradual arachnoid cyst. At surgery, a dural defect about 15 mm in length was identified, into which gliotic spinal cord with arachnoid membrane herniated. The herniated spinal cord was reduced and the dural defect was repaired using Goretex. A postoperative MRI showed the spinal cord in the normal position, and her clinical symptoms improved. We reviewed the characteristics of spinal cord herniations according to the reported cases. These cases can be divided into 2 categories : spontaneous or idiopathic one and post-traumatic ones. The present case is thought to be an idiopathic one, in spite of the patient's blunt back trauma.

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