Anterior spinal hernia: an increasingly recognised cause of thoracic cord dysfunction.

AUTOR(ES)

White, B D

RESUMO

Two cases of anterior spinal hernia are presented. The medical literature is reviewed, the syndrome characterised, and its cause and treatment discussed. The patient is typically middle aged with a history of stepwise slowly progressive mid-thoracic anterior hemicord syndrome manifesting as hemianalgesia below the affected segment, followed by contralateral lower limb spasticity that develops into an asymmetric paraparesis with sparing of dorsal column sensation. Radiological investigation demonstrates an enlarged dorsal arachnoid space in association with an apparently focally narrowed thoracic cord, kinked towards the anterior dura. At operation the cord is found to be prolapsed into an anterolateral dural diverticulum. The most likely cause of this syndrome is anterior spinal artery segmental branch ischaemia, in a cord chronically incarcerated in a congenital anterior meningocele. This readily treatable condition should be considered in all cases of thoracic cord dysfunction and surgical repair effected early to prevent stepwise progression to paraplegia.

Documentos Relacionados

• Genomic imprinting as a cause of disease: Is increasingly recognised, especially after assisted reproduction
• Ependymal cyst of the thoracic spinal cord
• Significance of abnormal pattern electroretinography in anterior visual pathway dysfunction.
• Congenital spinal cord haemangioblastoma: another cause of spinal cord section syndrome in the newborn.
• Anorgasmia in anterior spinal cord syndrome.