Idiopathic Spinal Cord Herniation (ISCH): A Case Report.

Abstract

     Idiopathic spinal cord herniation (ISCH) is a rare cause of progressive spinal myelopathy, which frequently presents as Brown-Sequard syndrome. A 50 year old woman consulted for diffculty in walking. On examination, the patient reported sensory deficit of temperature on the left side, associated with diminished anal sensitivity. Nine months before consultation, a walking disorder began disturbing the activities of everyday life.A single case report with surgical treatment outcome. 
Idiopathic spinal cord herniation is a potentially treatable condition, which should be diagnosed early and treated. The surgical operation contributed clinical improvement in functional autonomy with modification in McCormick classification in our patient. Despite the existence of growing number of ISCH cases in the literature, misdiagnosis and choice of treatment remains a major concern. SCH is a rare clinical entity that seems to be increasing with the accessibility of MRI imaging. Preoperative diagnosis can be made with magnetic resonance imaging (MRI). ISCH should be considered as differential diagnosis of Brown-Sequard syndrome, especially after fourth decade of life. Although progression of neurologic deficits can be gradually slow, reducing surgically the cord hernia and repair of the defect are vital factors in preventing the deterioration and display reversible improvement. In recent reviews, patients who underwent surgery had better outcomes as with our case.