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Xu Y, Zhang Y, Luo Y, Qiu G, Liu Y, Zhao W, Wang Y. Thoracic ossification of the ligamentum flavum causing Brown-Séquard syndrome: a case report and literature review. J Int Med Res 2022; 50:3000605221110069. [PMID: 35903859 PMCID: PMC9340934 DOI: 10.1177/03000605221110069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Brown-Séquard syndrome (BSS) has many etiologies, including penetrating trauma, extramedullary tumors, and disc herniation. However, thoracic ossification of the ligamentum flavum (OLF) is an extremely rare cause of this syndrome. A 46-year-old woman with motor weakness in her right lower extremity and urinary retention was admitted to our department. Based on the results of physical examination, computed tomography, and magnetic resonance imaging, a diagnosis of BSS with OLF was considered. The patient underwent urgent conservative treatment. BSS is a rare condition characterized by hemisection or hemicompression of the spinal marrow. The herein-described case of incomplete BSS due to OLF responded to conservative treatment. However, the successful nonoperative management of this case is insufficient evidence to consider it as the standard of care. Therefore, emergency laminectomy decompression remains the standard of care for BSS.
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Affiliation(s)
- Yeqiu Xu
- Department of Orthopedic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, Hangzhou, P.R. China.,Department of Spine Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, P.R. China
| | - Yuanzhuang Zhang
- Department of Spine Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, P.R. China
| | - Yinzhou Luo
- Department of Spine Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, P.R. China
| | - Guanzhen Qiu
- Department of Spine Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, P.R. China
| | - Yize Liu
- Department of Spine Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, P.R. China
| | - Wei Zhao
- Department of Spine Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, P.R. China
| | - Yong Wang
- Department of Orthopedic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, Hangzhou, P.R. China.,Department of Spine Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, P.R. China
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Randhawa PS, Roark C, Case D, Seinfeld J. Idiopathic Spinal Cord Herniation Associated With a Thoracic Disc Herniation: Case Report, Surgical Video, and Literature Review. Clin Spine Surg 2020; 33:222-229. [PMID: 32101990 PMCID: PMC7337104 DOI: 10.1097/bsd.0000000000000896] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 04/19/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this publication is to present a case of idiopathic spinal cord herniation (ISCH) associated with a transdural disk herniation, demonstrate an operative technique used to treat this condition and provide an updated review the literature. BACKGROUND CONTEXT ISCH is an infrequent condition that can cause progressive myelopathy leading to severe neurological dysfunction. This condition is characterized by ventral displacement of the spinal cord across a defect in the dura, either congenital or acquired, resulting in vascular compromise and adhesion that subsequently causes injury to the spinal cord. We present the management of such a patient, in addition to a review of the literature regarding management of ISCH. METHODS This patient underwent surgery using the dural graft sling technique for repair of the dural defect and restoration of normal spinal cord position within the thecal sac. A review of the literature revealed a total of 171 patients supplemented by our 1 patient, which were then analyzed. RESULTS The majority of patients, treated with a variety of surgical techniques, experienced improvements in symptomatology. Our patient experienced significant improvement in symptomatology. CONCLUSIONS Although ISCH is a rare clinical condition that causes myelopathy, patients managed with surgery generally, though not universally, have a favorable neurological outcome. The associated surgical technique video demonstrates the dural sling technique for the treatment of this rare disorder.
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Affiliation(s)
- Pal S Randhawa
- CU Department of Neurosurgery, University of Colorado, Aurora, CO
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Ventral Longitudinal Intraspinal Fluid Collection in Patients with Cervical Disc Herniation: A Report of Two Cases. Case Rep Orthop 2020; 2020:3439403. [PMID: 32257482 PMCID: PMC7125508 DOI: 10.1155/2020/3439403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 03/16/2020] [Indexed: 11/17/2022] Open
Abstract
We encountered two cases of cervical disc herniation, wherein cerebrospinal fluid collection in the ventral epidural space between the cervical spine and the thoracic spine was noted. The patients, two women aged 71 and 43 years, were diagnosed with cervical disc herniation and underwent anterior cervical discectomy and fusion. Unexpected cerebrospinal fluid leakage was observed prior to exposure of the dura mater. Notably, the dura mater was intact following the removal of the herniated disc in both cases. No cerebrospinal fluid leakage symptoms were observed, and relief from the neurological symptoms related to the cervical disc herniation was observed in both cases following the surgery. Findings of preoperative magnetic resonance imaging and computed tomography myelography were carefully reviewed, retrospectively. Both patients presented with similar features including expansion of cerebrospinal fluid collection in the ventral epidural space between the cervical spine and the thoracic spine. These observed features were similar to those of superficial siderosis, which is a form of duropathy—a disease caused by dural defects. Therefore, the patients in this case study might have a subclinical duropathy with associated cervical disc herniation.
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Groen RJ, Lukassen JN, Boer GJ, Vergeer RA, Coppes MH, Drost G, Middel B. Anterior Thoracic Spinal Cord Herniation: Surgical Treatment and Postoperative Course. An Individual Participant Data Meta-Analysis of 246 Cases. World Neurosurg 2019; 123:453-463.e15. [DOI: 10.1016/j.wneu.2018.11.229] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/25/2018] [Accepted: 11/27/2018] [Indexed: 12/16/2022]
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Dorsal Thoracic Arachnoid Abnormalities. Neuroradiology 2019. [DOI: 10.1016/b978-0-323-44549-8.00036-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Beck J, Häni L, Ulrich CT, Fung C, Jesse CM, Piechowiak E, Z’Graggen W, Meier N, Raabe A. Diagnostic challenges and therapeutic possibilities in spontaneous intracranial hypotension. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2018. [DOI: 10.1177/2514183x18787371] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Jürgen Beck
- Department of Neurosurgery, University Hospital of Bern, Bern, Switzerland
- Department of Neurosurgery, Medical Center—University of Freiburg, Freiburg, Germany
| | - Levin Häni
- Department of Neurosurgery, University Hospital of Bern, Bern, Switzerland
| | | | - Christian Fung
- Department of Neurosurgery, University Hospital of Bern, Bern, Switzerland
- Department of Neurosurgery, Medical Center—University of Freiburg, Freiburg, Germany
| | | | - Eike Piechowiak
- University Institute of Diagnostic and Interventional Neuroradiology, University Hospital of Bern, Bern, Switzerland
| | - Werner Z’Graggen
- Department of Neurosurgery, University Hospital of Bern, Bern, Switzerland
- Department of Neurology, University Hospital of Bern, Bern, Switzerland
| | - Niklaus Meier
- Department of Neurology, University Hospital of Bern, Bern, Switzerland
| | - Andreas Raabe
- Department of Neurosurgery, University Hospital of Bern, Bern, Switzerland
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Bartels RHMA, Brunner H, Hosman A, van Alfen N, Grotenhuis JA. The Pathogenesis of Ventral Idiopathic Herniation of the Spinal Cord: A Hypothesis Based on the Review of the Literature. Front Neurol 2017; 8:476. [PMID: 28955299 PMCID: PMC5601982 DOI: 10.3389/fneur.2017.00476] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 08/28/2017] [Indexed: 12/29/2022] Open
Abstract
Idiopathic ventral herniation of the spinal cord (SC) is not often encountered in daily practice. Its clinical prevalence, however, will increase through increasing awareness and more frequent use of MRI. A clear explanation of its pathophysiology has never been formulated. It was hypothesized that the findings during surgery might indicate the real causative mechanism. An extensive literature search was performed, using Embase, PubMed, and Google Scholar. Titles and abstracts were screened by two investigators, using strict inclusion and exclusion criteria. Reference lists of the full paper versions of each included article were checked. The following data were registered for the articles included: age, gender, level of herniation, relation to intervertebral disk, duration of symptoms, findings from surgery, and outcomes. Nine cases treated at our department were added. A total of 117 articles reporting on 259 patients were included. Including our cases, 268 patients were reviewed. Females outnumbered males (160/100). The mean age was 51.3 ± 12.0 years. In 236 patients, the duration of symptoms was reported: 55.5 ± 55.6 months. In 178 patients, the intraoperative findings for the herniated part of the SC were not mentioned. In 59 patients, a tumor-like extrusion was seen, without any alteration to the SC. Deformation of the SC itself was never observed. Biopsies of these structures were without clinical consequence. Based on the intraoperative findings reported in literature and the cases presented, acquired causes, such as trauma and erosion of the dura due to a herniated disk, were not plausible. We hypothesize that a non-functioning appendix to the SC can only develop during an early embryologic phase, in which several layers separate. We propose renaming this entity as congenital transdural appendix of the SC.
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Affiliation(s)
- Ronald H M A Bartels
- Department of Neurosurgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Han Brunner
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
| | - Allard Hosman
- Department of Orthopedic Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nens van Alfen
- Department of Neurology and Clinical Neurophysiology, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - J André Grotenhuis
- Department of Neurosurgery, Radboud University Medical Center, Nijmegen, Netherlands
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Sadek AR, Nader-Sepahi A. Idiopathic thoracic intravertebral spinal cord herniation. Br J Neurosurg 2016; 32:297-298. [DOI: 10.1080/02688697.2016.1265091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ahmed-Ramadan Sadek
- Department of Neurosurgery, Wessex Neurological Centre, University Hospital Southampton, Southampton, UK
- Division of Clinical Neurosciences, School of Medicine, University of Southampton, Southampton, UK
| | - Ali Nader-Sepahi
- Department of Neurosurgery, Wessex Neurological Centre, University Hospital Southampton, Southampton, UK
- Division of Clinical Neurosciences, School of Medicine, University of Southampton, Southampton, UK
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Ju MW, Choi SW, Youm JY, Kwon HJ. Idiopathic Spinal Cord Herniation Presented as Brown-Sequard Syndrome : A Case Report and Surgical Outcome. J Korean Neurosurg Soc 2015; 58:294-7. [PMID: 26539277 PMCID: PMC4630365 DOI: 10.3340/jkns.2015.58.3.294] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 07/18/2015] [Accepted: 08/04/2015] [Indexed: 12/27/2022] Open
Abstract
Spinal cord herniation is a rare condition that has become increasingly recognised in the last few years. The authors report a case of idiopathic spinal cord herniation in a 33 year old woman performed with progressive Brown-Sequard syndrome. The diagnosis was made on MR imaging. After repairing the herniation, the patient made a gradual improvement. Potential causes are discussed, including a possible role of dural defect. In conclusion, idiopathic spinal cord herniation is a potentially treatable condition that should be more readily diagnosed that increasing awareness and improved imaging techniques.
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Affiliation(s)
- Min-Wook Ju
- Department of Neurosurgery, Chungnam National University Hospital, Daejeon, Korea
| | - Seung-Won Choi
- Department of Neurosurgery, Chungnam National University Hospital, Daejeon, Korea
| | - Jin-Young Youm
- Department of Neurosurgery, Chungnam National University Hospital, Daejeon, Korea
| | - Hyon-Jo Kwon
- Department of Neurosurgery, Chungnam National University Hospital, Daejeon, Korea
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Porrino J, Scherer KF, Gellhorn A, Avellino AM. Dural Herniation of the Spinal Cord: A Rare Cause of Myelopathy With Unique Imaging Features. PM R 2014; 6:1063-5. [DOI: 10.1016/j.pmrj.2014.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 05/28/2014] [Accepted: 06/10/2014] [Indexed: 10/25/2022]
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Summers JC, Balasubramani YV, Chan PCH, Rosenfeld JV. Idiopathic spinal cord herniation: Clinical review and report of three cases. Asian J Neurosurg 2013; 8:97-105. [PMID: 24049553 PMCID: PMC3775190 DOI: 10.4103/1793-5482.116386] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Idiopathic spinal cord herniation (ISCH) is a rare condition, of unknown pathogenesis, that primarily affects the thoracic spinal cord. It is characterized by ventral displacement of the spinal cord through a dural defect. The aim of this study was to review the literature and to present a retrospective single center experience with three cases of ISCH. The literature review analyzed a total of 78 relevant publications on ISCH, which included a total of 171 patients, supplemented with 3 patients treated at our institution. Numerous case reports have demonstrated improvement in clinical outcomes after surgery; however, follow-up is predominantly short, data are incomplete, the condition is frequently misdiagnosed, and it is difficult to predict which patients will benefit from surgery. We identified 159 cases treated with surgical management. The mean symptom duration was 54 months, and the mean follow-up 33 months. The result at follow-up was improved neurological outcome in 74%, unchanged result in 18%, and worse outcome in 8%. There were 15 cases of conservative management, with mean symptom duration 52 months and mean follow-up 33 months. The neurological outcome was unchanged in 100%. ISCH is a rare condition causing progressive thoracic myelopathy, and the natural history is unknown. There is a lack of evidence-based treatment strategies, and the majority of cases are treated with surgical management at diagnosis. Management of ISCH needs to be individualized for each patient, and clinicians should be encouraged to report new cases, standardize case reports, and ensure long-term follow-up.
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Affiliation(s)
- Johanne C Summers
- Department of Neurosurgery, The Alfred Hospital, Victoria, Australia
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Prada F, Saladino A, Giombini S, Erbetta A, Saini M, DiMeco F, Lodrini S. Spinal cord herniation: management and outcome in a series of 12 consecutive patients and review of the literature. Acta Neurochir (Wien) 2012; 154:723-30. [PMID: 22290791 DOI: 10.1007/s00701-011-1265-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Accepted: 12/21/2011] [Indexed: 12/01/2022]
Abstract
BACKGROUND Spinal cord herniation is a rare entity that has been recognized and described with increasing frequency in the past few years. It is characterized by herniation of the spinal cord through an anterior dural defect. In their study of 12 cases, the authors attempt to develop management and treatment guidelines for patients suffering from this condition. METHODS A retrospective analysis of the medical files was carried out in a series of 12 consecutive patients treated at our Institution between 1998 and 2011 for spinal cord herniation. The clinical, radiological and surgical findings, management and outcome were reviewed. RESULTS The male:female ratio was 5:7, with a mean age of 47 years (range 26–71 years). All patients presented a progressively worsening symptomatology. Symptoms at presentation included progressive myelopathy, corticospinal tract sign, algoparesthesia and sphincter dysfunction. The radiological appearance was uniform. All the lesions were located between the T2 and T8 vertebrae. One patient was initially managed conservatively. All patients underwent surgical correction via a posterior approach, with reduction of the herniated spinal cord, the positioning of a muscular autograft to fill the anterior cavity and closure of the dural defect with an artificial dural patch. Six patients showed improvement of preoperative symptomatology at follow-up, while the others remained free from symptom progression. CONCLUSIONS The authors present one of the largest studies to date regarding patients with spinal cord herniation and emphasize that the possibility of this condition must be kept in mind when addressing all patients with progressive myelopathy.
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Affiliation(s)
- Francesco Prada
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy.
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Superficial siderosis due to dural defect with thoracic spinal cord herniation. J Neurol Sci 2012; 312:170-2. [DOI: 10.1016/j.jns.2011.07.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 06/22/2011] [Accepted: 07/20/2011] [Indexed: 11/23/2022]
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Brus-Ramer M, Dillon WP. Idiopathic thoracic spinal cord herniation: retrospective analysis supporting a mechanism of diskogenic dural injury and subsequent tamponade. AJNR Am J Neuroradiol 2011; 33:52-6. [PMID: 22158920 DOI: 10.3174/ajnr.a2730] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE tSCH in the absence of spinal trauma or surgery is a rare disorder for which numerous mechanisms have been proposed. Here, we have conducted an analysis of images in all published reports of idiopathic tSCH and identified evidence supporting a pathogenesis in which anterior dural erosion at thoracic levels generates a CSF leak that pushes adjacent spinal tissue to tamponade the dural defect, causing progressive myelopathy. Additionally, we describe a case of tSCH in which postural headache was a significant symptom before myelopathy. This finding suggests that tSCH pathogenesis may be related to spontaneous intracranial hypotension. MATERIALS AND METHODS Published imaging from all available prior case reports in the scientific literature was reviewed to determine whether tSCH occurred at the disk or bone level. The presence of EDF, HNP, or an osteophyte in the spinal canal was determined from review of published images. Additionally, 3 previously unreported cases from the teaching files of our department were assessed by using these criteria. RESULTS In greater than two-thirds (47 of 67) of identified cases with published images, tSCH occurred at a disk level. When assessment was possible, EDF, HNP, and osteophytes were present in 26.8%, 30.7%, and 26.2% of cases, respectively. Overall, 52.3% of cases with published images demonstrated evidence of these abnormalities. CONCLUSIONS Our analysis of published imaging indicates that tSCH occurs preferentially at spinal levels and with imaging findings consistent with dural injury that support the proposed etiology of this disorder.
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Affiliation(s)
- M Brus-Ramer
- Department of Radiology, University of California, San Francisco, 94143, USA
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Novak K, Widhalm G, de Camargo AB, Perin N, Jallo G, Knosp E, Deletis V. The value of intraoperative motor evoked potential monitoring during surgical intervention for thoracic idiopathic spinal cord herniation. J Neurosurg Spine 2011; 16:114-26. [PMID: 22117142 DOI: 10.3171/2011.10.spine11109] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Thoracic idiopathic spinal cord herniation (TISCH) is a rare neurological disorder characterized by an incarceration of the spinal cord at the site of a ventral dural defect. The disorder is associated with clinical signs of progressive thoracic myelopathy. Surgery can withhold the natural clinical course, but surgical repair of the dural defect bears a significant risk of additional postoperative motor deficits, including permanent paraplegia. Intraoperative online information about the functional integrity of the spinal cord and warning signs about acute functional impairment of motor pathways could contribute to a lower risk of permanent postoperative motor deficit. Motor evoked potential (MEP) monitoring can instantly and reliably detect dysfunction of motor pathways in the spinal cord. The authors have applied MEPs during intraoperative neurophysiological monitoring (IOM) for surgical repair of TISCH and have correlated the results of IOM with its influence on the surgical procedure and with the functional postoperative outcome. METHODS The authors retrospectively reviewed the intraoperative neurophysiological data and clinical records of 4 patients who underwent surgical treatment for TISCH in 3 institutions where IOM, including somatosensory evoked potentials and MEPs, is routinely used for spinal cord surgery. In all 4 patients the spinal cord was reduced from a posterior approach and the dural defect was repaired using a dural graft. RESULTS Motor evoked potential monitoring was feasible in all patients. Significant intraoperative changes of MEPs were observed in 2 patients. The changes were detected within seconds after manipulation of the spinal cord. Monitoring of MEPs led to immediate revision of the placement of the dural graft in one case and to temporary cessation of the release of the incarcerated spinal cord in the other. Changes occurred selectively in MEPs and were reversible. In both patients, transient changes in intraoperative MEPs correlated with a reversible postoperative motor deficit. Patients without significant changes in somatosensory evoked potentials and MEPs demonstrated no additional neurological deficit postoperatively and showed improvement of motor function during follow-up. CONCLUSIONS Surgical repair of the dural defect is effected by release and reduction of the spinal cord and insertion of dural substitute over the dural defect. Careful monitoring of the functional integrity of spinal cord long tracts during surgical manipulation of the cord can detect surgically induced impairment. The authors' documentation of acute loss of MEPs that correlated with reversible postoperative motor deficit substantiates the necessity of IOM including continuous monitoring of MEPs for the surgical treatment of TISCH.
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Affiliation(s)
- Klaus Novak
- Department of Neurosurgery, Medical University of Vienna, Austria.
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Kwong Y, Jakanani G, Rao N, Fang CSJ. MRI findings in herniation of the spinal cord. J Radiol Case Rep 2010; 4:1-5. [PMID: 22470690 DOI: 10.3941/jrcr.v4i10.528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Herniation of the spinal cord is a rare condition that causes non specific neurological deficits that are often a diagnostic challenge to clinicians. Despite several reports in the neurosurgical literature, it is only recently that the imaging appearances of this condition have come to be recognised, due mainly to the widespread adoption of spinal MRI. It is important for radiologists to recognise the telltale MRI features of this condition, as several cases have undergone initial misdiagnosis, resulting in delayed treatment We present a case with typical imaging features to familiarise radiologists with this condition, as it is likely that more cases will come to the fore, with more spinal MRIs being performed.
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Affiliation(s)
- Yune Kwong
- Department of Radiology, Royal Derby Hospital, Derby, UK
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