{"title":"Thoracic Spinal Cord Herniation- Delayed Diagnosis is a Major Concern.","authors":"A. Hussain, A. Khorsandi, M. Gowan, J. Daniel","doi":"10.5580/92a","DOIUrl":null,"url":null,"abstract":"A 54 year-old man presented with 3 years of progressive left foot drop and 4 months of proximal weakness in right leg. Hypoesthesia between left T8 and T10 levels. There was 0/5 strength of left ankle dorsiflexors, invertors and evertors. There was 3/5 strength of left hamstring, iliopsoas and right extensor digitorum brevis. No abdominal reflex but brisk ankle and knee jerks. Babinski’s signs with increased tone in both lower extremities. MRI (Figure: A-F) of thoracic spine showed T5/T6 anterior thoracic spinal cord herniation. It is uncommon and often diagnosed late or misdiagnosed as a presumed posterior intradural arachnoid cyst.1,2 Prompt diagnosis and treatment can prevent severe disability. Figure 1 Figure: Pre-operative images: Sagittal spin echo T1-WI (A), FSE T2-WI (B), Axial FSE T2-WI (C) – Left anterolateral herniation (C), There is anterior displacement of the thoracic cord at T5/T6 level within the ventral epidural space abutting directly the posterior aspect of the T5/T6 disc and the corresponding vertebral body. Post-operative images: Sagittal spin echo T1-WI (D), FSE T2-WI (E), Axial FSE T2-WI (F), showing resolution of thoracic cord herniation at T5/T6 disc level with gliotic anterior cord atrophy.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Internet Journal of Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5580/92a","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
A 54 year-old man presented with 3 years of progressive left foot drop and 4 months of proximal weakness in right leg. Hypoesthesia between left T8 and T10 levels. There was 0/5 strength of left ankle dorsiflexors, invertors and evertors. There was 3/5 strength of left hamstring, iliopsoas and right extensor digitorum brevis. No abdominal reflex but brisk ankle and knee jerks. Babinski’s signs with increased tone in both lower extremities. MRI (Figure: A-F) of thoracic spine showed T5/T6 anterior thoracic spinal cord herniation. It is uncommon and often diagnosed late or misdiagnosed as a presumed posterior intradural arachnoid cyst.1,2 Prompt diagnosis and treatment can prevent severe disability. Figure 1 Figure: Pre-operative images: Sagittal spin echo T1-WI (A), FSE T2-WI (B), Axial FSE T2-WI (C) – Left anterolateral herniation (C), There is anterior displacement of the thoracic cord at T5/T6 level within the ventral epidural space abutting directly the posterior aspect of the T5/T6 disc and the corresponding vertebral body. Post-operative images: Sagittal spin echo T1-WI (D), FSE T2-WI (E), Axial FSE T2-WI (F), showing resolution of thoracic cord herniation at T5/T6 disc level with gliotic anterior cord atrophy.