Fact-sheet: Transdural spinal cord herniation
Updated on 04/29/2021 at 9:22 AM
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Definition
Herniation of the spinal cord, at the thoracic level, through a defect in the anterolateral or anterior dural wall.
The origin of this defect is unknown.
Transdural spinal cord herniation is a rare cause of progressive myelopathy
Clinical features
Most often: Brown-Séquard syndrome, which may progress to severe paraparesis.
MRI
Anterior angulation of the spinal cord (sagittal plane).
Effacement of the anterior subarachnoid spaces.
Anterolateral or anterior displacement of the spinal cord with apposition to the dura mater (axial plane).
Obtain sagittal and axial T2 sequences without flow artifact compensation, as flow artifacts are present at the level of the lesion.
Management
Depending on the clinical symptoms:
- Simple follow-up.
- Neurosurgical treatment: laminectomy with dural suspension.
Differential diagnosis
Arachnoid cyst: absence of flow artifacts opposite the lesion