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1000 Titel
  • Long-term course of anterior spinal cord herniation presenting with an upper motor neuron syndrome: case report illustrating diagnostic and therapeutic implications
1000 Autor/in
  1. Regensburger, Martin |
  2. Schlachetzki, Johannes C. M. |
  3. Klekamp, Jörg |
  4. Doerfler, Arnd |
  5. Winkler, Jürgen |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-08-29
1000 Erschienen in
1000 Quellenangabe
  • 20(1):321
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s12883-020-01891-1 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455782/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!Anterior spinal cord herniation (aSCH) is a rare cause of myelopathy which may present as pure motor syndrome and mimic other degenerative diseases of the spinal cord. In slowly progressive cases, diagnosis may be impeded by equivocal imaging results and mistaken for evolving upper motor neuron disease. As early imaging studies are lacking, we aimed to provide a detailed description of imaging and neurophysiology findings in a patient with aSCH, focusing on the early symptomatic stages.!##!Case presentation!#!We here present the case of a 51-year old male patient with an episode of pain in the right trunk and a normal spinal MRI. After a symptom-free interval of 8 years, spasticity and paresis evolved in the right leg. There was subtle ventral displacement and posterior indentation of the thoracic spinal cord on MRI which, in retrospect, was missed as an early sign of aSCH. After another 3 years, symptoms spread to the left leg and a sensory deficit of the trunk became evident. Follow-up MRI now clearly showed an aSCH. Neurosurgical intervention consisted of remobilization of the herniated spinal cord and patch closure of the dura defect. Over the following years, motor and sensory symptoms partially improved.!##!Conclusions!#!The history of this patient with aSCH illustrates the importance of careful longitudinal clinical follow-up with repeated imaging studies in progressive upper motor neuron syndromes. Specific attention should be paid to a history of truncal pain and to MRI findings of a ventrally displaced spinal cord. Neurosurgical intervention may halt the progression of herniation.
1000 Sacherschließung
lokal Paresis/etiology [MeSH]
lokal Spinal cord herniation
lokal Motor Neuron Disease/diagnosis [MeSH]
lokal Humans [MeSH]
lokal Syndrome [MeSH]
lokal Middle Aged [MeSH]
lokal Neurosurgical Procedures [MeSH]
lokal Evoked potentials
lokal Spinal Cord Diseases/diagnosis [MeSH]
lokal Thoracic Vertebrae/surgery [MeSH]
lokal Magnetic Resonance Imaging [MeSH]
lokal Male [MeSH]
lokal Hernia/diagnosis [MeSH]
lokal Spasticity
lokal Movement disorders
lokal Case Report
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0002-2172-7386|https://frl.publisso.de/adhoc/uri/U2NobGFjaGV0emtpLCBKb2hhbm5lcyBDLiBNLg==|https://frl.publisso.de/adhoc/uri/S2xla2FtcCwgSsO2cmc=|https://frl.publisso.de/adhoc/uri/RG9lcmZsZXIsIEFybmQ=|https://frl.publisso.de/adhoc/uri/V2lua2xlciwgSsO8cmdlbg==
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