Author(s):
De Smet, Bernardo ; Pinheiro, Teresa ; Fonseca, Lino
Date: 2023
Persistent ID: http://hdl.handle.net/10400.17/5058
Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
Subject(s): Brown -Séquard; Dural defect; Paraparesis; Brown -Séquard; Brown -Séquard; Dural defect; Dural defect; Paraparesis; Paraparesis
Description
Idiopathic spinal cord herniation is a rare disorder, consisting of a ventral displacement of the spinal cord through a dural defect. The resulting adhesion and vascular compromise lead to neurological impairment. We report the case of a 54yearold male, with a previous urological surgery resulting in chronic vesical catheterization, with a worsening paraparesis associated with anesthesia below T10. The magnetic resonance imaging showed a ventral displacement of the spinal cord at T7/T8 with an enlarged posterior subarachnoid space at that level. A fourlevel laminotomy was performed followed by spinal cord herniation reduction and closure of the anterior dural defect with a dural replacement. The patient had a partial recovery of his motor deficits regaining his ability to walk with the support of a single crutch. The purpose of this study was to highlight the existence of this extremely rare cause of paraparesis, which is often misdiagnosed.