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Acta Neurochirurgica

, Volume 160, Issue 3, pp 467–470 | Cite as

Disc herniation, occult on preoperative imaging but visualized microsurgically, as the cause of idiopathic thoracic spinal cord herniation

  • Christian T. Ulrich
  • Christian Fung
  • Eike Piechowiak
  • Jan Gralla
  • Andreas Raabe
  • Jürgen Beck
Case Report - Spine
  • 184 Downloads

Abstract

Idiopathic spinal cord herniation (ISCH) through an anterior dural defect is rare and the cause is uncertain. Recently, through interpreting imaging studies, disc herniation was proposed to be a major cause for ISCH. We describe the case of a 50-year-old woman with progressive myelopathy who was diagnosed with a thoracic spinal cord herniation. Microsurgical exploration revealed an anterior vertical dural defect and a small concomitant disc herniation, occult on the preoperative imaging, which caused the dural defect and led to ISCH. This intraoperative finding corroborates the emerging notion that disc herniation is the underlying cause of ISCH.

Keywords

Idiopathic spinal cord herniation Disc protrusion Dural erosion Microsurgical exploration Spontaneous intracranial hypotension 

Abbreviations

CSF

Cerebrospinal fluid

ISCH

Idiopathic spinal cord herniation

MRI

Magnetic resonance imaging

Notes

Contribution of authors

Christian T. Ulrich: conception and design, acquisition of data, analysis and interpretation of data, drafting the article, critically revising the article, administrative/technical/material support, and study supervision

Christian Fung: acquisition of data, analysis and interpretation of data, and critically revising the article

Eike Piechowiak: acquisition of data, analysis and interpretation of data, and critically revising the article

Jan Gralla: acquisition of data, analysis and interpretation of data, and critically revising the article

Andreas Raabe: acquisition of data, analysis and interpretation of data, and critically revising the article

Jürgen Beck: conception and design, acquisition of data, analysis and interpretation of data, critically revising the article, and study supervision

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Patient consent

The patient has consented to submission of this case report to the journal.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Christian T. Ulrich
    • 1
  • Christian Fung
    • 1
  • Eike Piechowiak
    • 2
  • Jan Gralla
    • 2
  • Andreas Raabe
    • 1
  • Jürgen Beck
    • 1
  1. 1.Department of NeurosurgeryBern University Hospital, InselspitalBernSwitzerland
  2. 2.Institute of NeuroradiologyBern University Hospital, InselspitalBernSwitzerland

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