Ventral cord herniation

Case contributed by A.Prof Frank Gaillard

Presentation

Right sided loss of proprioception, touch, vibration sense and paralysis, with left sided loss of pain and temperature sensation.

Patient Data

Age: 55 years
MRI

Thoracic MRI

At T6/7 the thoracic cord is focally displaced anteriorly and to the right, and markedly distorted without convincing cord signal abnormality. Best seen on sagittal imaging part of the cord appears to extend beyond the expected location of the theca. Within the CSF space dorsal to the cord, no focal lesion can be identified. No abnormal enhancement. Normal CSF flow voids are noted.

Small T12/L1 left paracentral disc protrusion results is no canal stenosis or cord compression. The conus terminates at L1/2 is normal in appearance. All other levels of the thoracic cord are unremarkable.

Conclusion: Appearances are characteristic of idiopathic ventral cord herniation at T6/7, presumably due to a congenital dural defect.

Case Discussion

Patient went on to have surgery which confirmed the diagnosis. The cord was reduced and dural defect repaired. The patient went on to make an uneventful recovery and recovered most function prior to discharge.
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Case information

rID: 44719
Case created: 3rd May 2016
Last edited: 3rd Jun 2016
Inclusion in quiz mode: Included

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