Cervical intradural disc herniation and cerebrospinal fluid leak
Ritesh Kansal1, Amit Mahore, Sanjay Kukreja
1Department of Neurosurgery, L.T.M.G. Hospital, Sion, Mumbai, India. drriteshkansal@yahoo.co.in
Neurology India
|July 12, 2011
Summary
Cervical intradural disc herniation (IDH) is a rare spinal condition. This case report details a patient with C5/6 IDH who experienced leg weakness, improved after surgery, but developed a cerebrospinal fluid leak.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Neurology
Background:
- Cervical intradural disc herniation (IDH) is an exceptionally rare spinal pathology, with limited documented cases.
- Understanding the clinical presentation and management of cervical IDH is crucial due to its rarity.
Observation:
- A 45-year-old male presented with acute right lower limb weakness after heavy lifting.
- Cervical spine magnetic resonance imaging revealed a C5/6 disc prolapse with extension into the intradural space.
Findings:
- Surgical C5/6 discectomy via an anterior cervical approach was performed.
- Post-operatively, the patient showed improvement in stiffness but subsequently developed a cerebrospinal fluid (CSF) leak.
- The CSF leak was successfully managed with multiple lumbar punctures.
Implications:
- This case highlights the importance of considering IDH in the differential diagnosis of acute cervical radiculopathy or myelopathy.
- Management of cervical IDH requires careful surgical planning and awareness of potential postoperative complications like CSF leaks.
- Successful resolution of CSF leak with conservative management (lumbar punctures) is demonstrated.
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