Herniaci贸n transdural espont谩nea de la m茅dula espinal con recidiva temprana

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• 作者：A.P. Soriano Guill&#233 ; np>ap>p> ; p>p>ton.sor@terra.esp> ; E. Mayayo Sinu&#233 ; sp>bp> ; I. Villarreal Salcedop>ap> ; M.A. Marí ; n Cá ; rdenasp>bp>
• 关键词：Defecto dural ; Herniació ; n medular ; Transdural ; Resonancia magné ; tica ; Recidiva
• 刊名：Rehabilitaci贸n
• 出版年：2010
• 期刊代码：pca300_00487120
• 类别：med
• 出版时间：October-December 2010
• 卷：44
• 期：4
• 页码：371-375
• 文件大小：492 K

摘要

<p>Idiopathic transdural spinal cord herniation (ITSCH) is a little-known medical condition that causes large duration progressive myelopathy that can be diagnosed based on the radiological manifestations on magnetic resonance imaging (MRI) prior to surgery.<p>We present the case of a 61-year-old woman with spastic myelopathy (Brown-Sequard syndrome) and conclusive diagnosis of ITSCH by MRI. Surgery was carried out with reduction of the spinal cord and repair of the dural defect with clinical improvement but paraplegia at the metameric D5 level (ASIA D). However, six months after surgery a new progressive neurologic worsening was present with recurrent spinal cord herniation diagnosis confirmed with MRI. A second surgery was carried out, covering the dural defect with synthetic patch.<p>Although persistence of neurologic deficits after spinal surgery is common, recurrence of spinal cord herniation is extremely rare. It must be considered as a possible differential diagnosis in case of progressive neurologic deterioration after an initial favorable course.