表现为布朗 - 塞卡尔综合征和霍纳综合征的自发性颈椎硬膜内椎间盘突出症：从一个非常独特的病例中吸取的教训
Spontaneous cervical intradural disc herniation presenting with Brown-Séquard and Horner's syndrome: lesson learned from a very unique case.
作者信息
Baudracco Irene, Grahovac Gordan, Russo Vittorio M
机构信息
Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, Queen Square, London, WC1N 3BG, UK.
出版信息
Eur Spine J. 2017 May;26(Suppl 1):218-221. doi: 10.1007/s00586-017-5044-4. Epub 2017 Mar 25.
PURPOSE
Cervical spontaneous intradural disc herniation (IDH) is an extremely rare condition. We describe a unique case of a patient presenting with a Brown-Séquard syndrome (BSS) and Horner's syndrome (HS). This study aimed to report an unusual case of spontaneous cervical intradural disc herniation that presented with Horner's and Brown-Séquard syndrome (BSS) and discuss difficulties in preoperative diagnosis and treatment difficulties of intradural cervical disc.
METHODS
Notes and images review, and analysis of the relevant literature.
RESULTS
A 45-year old female presented with acute Horner's syndrome and Brown-Séquard syndrome. The magnetic resonance imaging of cervical spine revealed C4-5 disc extrusion with cord compression. The patient underwent urgent decompression through an anterior cervical corpectomy and fusion. Patient fully recovered 6 months after disease onset.
CONCLUSION
We would like to emphasize that prompt and anterior cervical decompression is the treatment of choice, as it directly address the problem and allows dura repair in spontaneous cervical disc herniation.
目的
颈椎自发性硬膜内椎间盘突出症（IDH）极为罕见。我们描述了一例表现为布朗 - 塞卡尔综合征（BSS）和霍纳综合征（HS）的独特病例。本研究旨在报告一例伴有霍纳综合征和布朗 - 塞卡尔综合征的自发性颈椎硬膜内椎间盘突出症的罕见病例，并讨论术前诊断的困难以及颈椎硬膜内椎间盘的治疗难点。
方法
回顾病历和影像资料，并分析相关文献。
结果
一名45岁女性出现急性霍纳综合征和布朗 - 塞卡尔综合征。颈椎磁共振成像显示C4 - 5椎间盘突出伴脊髓受压。患者接受了前路颈椎椎体次全切除减压融合术。发病6个月后患者完全康复。
结论
我们想强调的是，及时进行前路颈椎减压是首选治疗方法，因为它能直接解决问题，并允许在自发性颈椎间盘突出症中进行硬脊膜修复。
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