Spinal Cord Ischemia Related to Disc Herniation: Case Report and a Review of the Literature

Aalbers, Marlien W.; Groen, Rob J. M.; Appelman, Auke P.A.; Heersema, Thea D J; Wokke, B.H.A.; Oterdoom, D L Marinus

doi:10.2147/imcrj.s316797

Cited by 4 publications

(4 citation statements)

References 10 publications

(12 reference statements)

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“…Intrinsically, the spinal cord is fed by sulco-commissural arteries originating from the ASA in a centrifugal fashion. Each sulco-commissural artery supplies half of the cord [ 8 ]. The ASA is more commonly involved, resulting in an ASA syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, eleven cases of spinal cord ischemia related to thoracic disc herniation have been reported, including only two cases of Brown-Sequard [ 2 , 3 ]. Therapeutic management was heterogeneous with two cases treated with surgery [ 8 , 10 ] and seven cases managed conservatively [ 2 , 11 – 15 ], with variable clinical outcome (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…Therapeutic management was heterogeneous with two cases treated with surgery [ 8 , 10 ] and seven cases managed conservatively [ 2 , 11 – 15 ], with variable clinical outcome (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

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Spinal cord ischemia revealed by a Brown-Sequard syndrome and caused by a calcified thoracic disc extrusion with spontaneous regression: a case report and review of the literature

Petrovic,

Le Forestier,

Pradat

et al. 2023

J Med Case Reports

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Background Thoracic disc herniation is relatively uncommon, accounting for less than 1% of all spinal herniations. Although most often asymptomatic, they may represent a rare cause of spinal cord ischemia. Case report We report the case of a healthy 43-year-old North African male who presented with a Brown-Sequard syndrome revealing a spinal cord ischemia caused by a thoracic disc extrusion. The initial MRI revealed a calcified disc extrusion at the level of T5-T6 without significant spinal cord compression or signal abnormality. A pattern consistent with a medullary ischemia only appeared 48 h later. The patient was treated conservatively with Aspirin and Heparin, which were discontinued later because of a negative cardiovascular work-up. The calcified disc extrusion, which was later recognized as the cause of the ischemia, decreased spontaneously over time and the patient recovered within a few months. Conclusions Our case highlights the challenge in diagnosing and managing this uncommon condition. We propose a literature review showing the different therapeutic strategies and their corresponding clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Spinal cord ischemia revealed by a Brown-Sequard syndrome and caused by a calcified thoracic disc extrusion with spontaneous regression: a case report and review of the literature

Petrovic,

Le Forestier,

Pradat

et al. 2023

J Med Case Reports

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show abstract

“…Proximálně a distálně se šířka kanálu zvětšuje na 19,8 mm v úrovni Th 12 a 18 mm v úrovni Th 1 (7). Jako mechanismus vzniku případného neurodeficitu se může uplatnit jak přímé mechanické poranění míchy, tak ischemie míchy způsobená útlakem míšních cév (1). Právě nejasná etiologie rozvoje neurodeficitu dolních končetin může být indikací k doplnění MRI poraněného segmentu páteře.…”

Section: úVodunclassified

Acute Traumatic Intervertebral Disc Herniation

SOUKUP,

ČERNÝ,

NOVOTNÝ

2023

ACHOT

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Acute traumatic intervertebral disc herniation of the thoracic spine is a rather rare injury with only a few reported cases to date. In this manuscript, we present a case of a 58-year-old male patient who sustained a car accident-related high-energy trauma, resulting in a disc herniation of the thoracic spine. Furthermore, we also discuss the possible implications of late diagnosis of such condition. The patient was initially referred from the Emergency Department as a case of head contusion with a left upper limb paresis.Due to only minimal bony trauma visible on the initial spine CT scan, the neurological deficit was attributed to the cranial trauma. The diagnosis of a traumatic disc herniation was therefore established only after the rapid onset of paraparesis, which gradually progressed into paraplegia, and a following spine MRI scan. Despite the subsequent urgent spinal decompression, the neurological functions of the lower limbs were not restored. This manuscript addresses the indications for performing MRI scans in polytrauma patients with a CT-verified spine trauma. Although it may be complicated to perform routine MRI scans in all such patients in daily practice, it can certainly help diagnose such injuries earlier and thus prevent potential permanent neurological damage to the patients.

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Delayed onset of anterior spinal artery syndrome caused by retropulsed bone fragment after kyphoplasty: Case report and literature review

Copeland,

Reeh,

D'Souza

et al. 2023

Interventional Pain Medicine

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Spinal Cord Ischemia Related to Disc Herniation: Case Report and a Review of the Literature

Cited by 4 publications

References 10 publications

Spinal cord ischemia revealed by a Brown-Sequard syndrome and caused by a calcified thoracic disc extrusion with spontaneous regression: a case report and review of the literature

Spinal cord ischemia revealed by a Brown-Sequard syndrome and caused by a calcified thoracic disc extrusion with spontaneous regression: a case report and review of the literature

Acute Traumatic Intervertebral Disc Herniation

Delayed onset of anterior spinal artery syndrome caused by retropulsed bone fragment after kyphoplasty: Case report and literature review

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