Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of idiopathic spinal cord herniation with incomplete Brown-Séquard syndrome

Yoko Tomoda, M.D.1)2), Tetsuo Ando, M.D., Ph.D.1), Ryo Hashimoto, M.D.3), Satoshi Nakamura, M.D.3), Motoo Kubota, M.D., Ph.D.3) and Toshio Fukutake, M.D., Ph.D.1)

1) Department of Neurology, Kameda Medical Center
2) Present Address: Department of Neurology, Kyoto University Graduate School of Medicine
3) Department of Neurospinology, Kameda Medical Center

A 50-year-old man was referred to our hospital with myelitis associated with a 10-months history of progressive muscle weakness in the left leg. Neurological examinations demonstrated diffuse muscle weakness of the left leg, touch hypoesthesia of the right leg, reduced pain sensation below the right nipple, left pyramidal sign, and urinary incontinence. On the basis of thoracic spinal MRI and thoracic CT myelography, revealing anterior displacement of the spinal cord and enlargement of the posterior subarachnoid space at the Th4 vertebral level, we diagnosed the patient as having idiopathic spinal cord herniation with incomplete Brown-Séquard syndrome. After microsurgical release of the spinal cord and subsequent covering of the anterior dural defect with an artificial dura mater, the symptoms improved without progression. Clinicians should consider spinal cord herniation as a cause of slowly progressive thoracic myelopathy with Brown-Séquard syndrome.
Full Text of this Article in Japanese PDF (1334K)

(CLINICA NEUROL, 62: 797|800, 2022)
key words: Brown-Séquard Syndrome, spinal cord herniation, duropathy, diagnose

(Received: 24-Mar-22)