Berbel A, Porta-Etessam J, Martínez-Salio A, Pérez-Martínez D A, Sáiz-Díaz R A, Rivas J J, Ruiz J
Servicio de Neurología, Hospital 12 de Octubre, Madrid, España.
Rev Neurol. 2001;32(1):54-7.
Idiopathic herniation of the spinal cord is a rarely diagnosed condition. It is important since this cause of paraparesis is potentially curable if diagnosis is made early. Our aim is to report a new case, review the relevant literature, describe the radiological findings and consider the etiopathogenic findings.
We report the case of a 56 year old man with increasing difficulty in walking attributed to stenosis of the lumbar spinal canal, which did not improve after laminectomy. On examination he had sensory and motor deficits compatible with the Brown-Séquard syndrome. Dorsal MR showed ventral displacement of the thoracic spinal cord with disappearance of the anterior subarachnoid space together with a posterior arachnoid cyst at the same site. A further operation was done at the same place and the cyst removed. However, it was impossible to free the spinal cord since there was severe spinal arachnoiditis. The patient made little improvement.
Herniation of the spinal cord is a rarely diagnosed condition. After careful study of the literature it seems that all patients present in a similar manner. Clinically there is a disorder of gait compatible with the Brown-Séquard syndrome. On MR there is sudden ventral displacement of the thoracic spinal cord, associated in some cases with an arachnoid cyst. When surgery is effective there is great improvement, so this diagnosis should be remembered in all cases of progressive paraparesis.
特发性脊髓疝是一种很少被诊断出来的疾病。鉴于这种截瘫病因如果早期诊断可能治愈，所以它很重要。我们的目的是报告一例新病例，回顾相关文献，描述影像学表现并探讨病因学发现。
我们报告一例56岁男性病例，其行走困难逐渐加重，归因于腰椎管狭窄，椎板切除术后病情未改善。检查发现他存在与布朗 - 塞卡尔综合征相符的感觉和运动障碍。胸椎磁共振成像（MR）显示胸段脊髓腹侧移位，蛛网膜下腔前部消失，同时在同一部位有一个后蛛网膜囊肿。在同一部位进行了进一步手术并切除了囊肿。然而，由于存在严重的脊髓蛛网膜炎，无法松解脊髓。患者改善甚微。
脊髓疝是一种很少被诊断出来的疾病。在仔细研究文献后，似乎所有患者的表现都相似。临床上存在与布朗 - 塞卡尔综合征相符的步态障碍。在MR上，胸段脊髓突然腹侧移位，某些病例伴有蛛网膜囊肿。当手术有效时，病情会有很大改善，所以在所有进行性截瘫病例中都应考虑这一诊断。
