Spontaneous cervical intradural disc herniation presenting with Brown-Séquard and Horner's syndrome: lesson learned from a very unique case

Eur Spine J. 2017 May;26(Suppl 1):218-221. doi: 10.1007/s00586-017-5044-4. Epub 2017 Mar 25.

Abstract

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.

Keywords: Brown-Séquard syndrome; Cervical corpectomy; Horner’s syndrome; OPLL; Spontaneous intradural cervical disc herniation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Disease
  • Brown-Sequard Syndrome / etiology*
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery
  • Decompression, Surgical / methods
  • Dura Mater / surgery
  • Female
  • Horner Syndrome / etiology*
  • Humans
  • Intervertebral Disc / surgery
  • Intervertebral Disc Displacement / complications*
  • Intervertebral Disc Displacement / diagnostic imaging
  • Intervertebral Disc Displacement / surgery
  • Magnetic Resonance Imaging
  • Middle Aged
  • Spinal Cord Compression / diagnostic imaging
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / surgery