Idiopathic Spinal Cord Herniation - An Extremely Rare Cause of Paraparesis: Case Report

De Smet, Bernardo; Pinheiro, Teresa; Fonseca, Lino

http://hdl.handle.net/10400.17/5058

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Authors

De Smet, Bernardo

Pinheiro, Teresa

Fonseca, Lino

Abstract(s)

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.