Spontaneous cervical intradural disc herniation presenting with Brown-Séquard and Horner's syndrome: lesson learned
Irene Baudracco1, Gordan Grahovac2, Vittorio M Russo2
1Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, Queen Square, London, WC1N 3BG, UK. Irene.baudracco@gmail.com.
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.
