Posttraumatic Transdural Spinal Cord Herniation – a Case Report

Czech version

Authors: Andrea Burgetová ¹; I. Kovářová ²; M. Vaněčková ¹; Z. Seidl ^1,3
Authors‘ workplace: Radiodiagnostická klinika 1. LF UK a VFN v Praze ¹; Neurologická klinika 1. LF UK a VFN v Praze ²; Vyšší zdravotnická škola, Praha ³
Published in: Cesk Slov Neurol N 2013; 76/109(1): 96-98
Category: Case Report

Overview

We describe a patient treated for a multiple sclerosis (MS)-like demyelinating disease. Magnetic resonance imaging (MRI) revealed a compressive fracture of the vertebral body T5 and transdural spinal cord herniation in this location. MRI was indicated due to worsening of clinical symptoms, suggestive of a spinal cord lesion. The patient had no history of spinal trauma, and we assume that the compressive fracture of vertebral body T5 resulted from osteoporosis due to long-term corticosteroid therapy. For these reasons, we do not know the exact timing of the spinal fracture and herniation. Post-traumatic spinal cord herniations are associated with variable time intervals of, usually, several years between the injury and clinical manifestation. There often is a gradual progression of clinical symptoms. A clinical picture of the presented patient is complicated by symptoms caused by MS. The aim of this manuscript is to demonstrate the options available for imaging of this relatively rare clinical unit on the background of clinical symptomatology. Neurosurgery can bring a significant improvement in patients with progression of clinical signs. Considerations on therapeutic management of our patient are further complicated by a possible overlap of clinical symptomatology with MS symptoms.

Key words:
spinal cord – herniation – fracture – magnetic resonance imaging – Brown-Séquard syndrome

Accepted for review:
17. 4. 2012

Accepted for print:
30. 7. 2012

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