Cervical intradural disc herniation, case report and reflection on preoperative imaging

Celano, Emma C.; Sayah, Anousheh; McGrail, Kevin M.

doi:10.1016/j.radcr.2019.06.004

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Choi et al ( 6 ) described 2 cases showing a focal defect in the posterior longitudinal ligament (PLL), and a triangular, central disc projection compressing the cord, which they designated a “hawk-beak sign”. Börm et al ( 7 ) and Celano et al ( 8 ) both found that the intradural disc was surrounded by a high signal intensity halo on T2-weighted imaging. Although not described by the authors, both the halo sign and a beak-like central projection are also present in a case reported by Baudracco et al ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

Intradural cervical herniated nucleus pulposus presentation and management: a case report

Yen¹,

Worley²,

Clair³

et al. 2023

AME Case Rep

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Background Intradural disc herniations (IDH) are uncommon and can be found in the cervical spine. It is commonly associated with Brown-Sequard syndrome (BSS). The case report describes cervical spine magnetic resonance imaging (MRI) findings that assists in identifying IDH pre-operatively and discusses surgical management. Case Description This is a case report regarding a 42-year-old obese male who developed atraumatic spontaneous bilateral upper extremity numbness, right upper extremity weakness and right lower extremity weakness. MRI showed a C6-7 herniated nucleus pulposus that focally protruded through the posterior longitudinal ligament with a beak-like projection similar to what has been described in previous reports. Clinical exam revealed an incomplete spinal cord injury (SCI) most consistent with BSS. He underwent anterior cervical discectomy and fusion at the level of C6-7. Intra-operatively, a disc fragment was found to be embedded in the dura. Three months post-operatively, the patient had persistent weakness in his right lower extremity but no longer had any bilateral upper extremity weakness. Conclusions An anterior cervical decompression and fusion was performed shortly after the patient presented, with adequate neurological recovery after 3 months. Advanced imaging with an MRI could lead to the diagnosis of an IDH and surgical intervention via the anterior approach could facilitate removal of the disc and adequate dura repair.

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Section: Discussionmentioning

confidence: 99%

Intradural cervical herniated nucleus pulposus presentation and management: a case report

Yen¹,

Worley²,

Clair³

et al. 2023

AME Case Rep

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Spontaneous Cervical Intradural Disc Herniation with Cerebrospinal Fluid Leak

Nathan

Saranraj

Balamurugan

2023

Journal of Spinal Surgery

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Cervical intradural disc herniation is a rare entity with only very few cases reported in the literature. Here, we discuss one such case of C6–C7 intradural disc herniation with neck pain and left-hand weakness. Fusion was not done, and a fat graft was used to seal the cerebrospinal fluid leak (CSF) leak with fibrin glue. Although difficult to diagnose preoperatively, cervical intradural disc herniation should be kept in mind by the surgeon to decide on the approach and to manage intraoperative CSF leak effectively.

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Cervical intradural disc herniation, case report and reflection on preoperative imaging

Cited by 2 publications

References 8 publications

Intradural cervical herniated nucleus pulposus presentation and management: a case report

Intradural cervical herniated nucleus pulposus presentation and management: a case report

Spontaneous Cervical Intradural Disc Herniation with Cerebrospinal Fluid Leak

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