From CHU Nîmes (G.C., D.R.), Hôpital Caremeau; and Clinique des Franciscaines 3 (J.P.H.), Nîmes, France.
Neurology. 2014 Apr 8;82(14):1290. doi: 10.1212/WNL.0000000000000286.
A 42-year-old man with a history of benign incidental dorsal trauma 5 years earlier presented with progressive weakness of the right leg for 2 years. Clinical examination revealed decreased left-sided pain, temperature, and light touch sensation below the level of T2, right leg weakness, normal proprioception, and increased deep tendon reflexes in the right leg, in absence of bladder dysfunction. Spinal MRI showed herniation of the ventral spinal cord to the left at level T1 (figure). A diagnosis of transdural spinal cord herniation (TSCH) was made. TSCH is a rare cause of progressive myelopathy. TSCH is reported after spinal trauma or herniated disc surgery.(1) Spontaneous cases are also described.(2) Patients usually present with a Brown-Séquard-like syndrome or progressive paraparesis.
一位 42 岁男性，5 年前有过良性偶然背部创伤史，现出现右腿进行性无力 2 年。临床检查显示 T2 以下左侧痛觉、温度觉和轻触觉减退，右腿无力，本体感觉正常，右侧深腱反射亢进，无膀胱功能障碍。脊髓 MRI 显示脊髓腹侧向左侧在 T1 水平突出（图）。诊断为硬脊膜下脊髓突出（TSCH）。TSCH 是进行性脊髓病的罕见原因。TSCH 报道见于脊髓创伤或椎间盘手术后。(1) 也有自发性病例的描述。(2) 患者通常表现为 Brown-Séquard 样综合征或进行性截瘫。
