Journal of medical case reports · 2023
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.
ОбзорКлинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Petrovic Sonja, Le Forestier Nadine, Pradat Pierre-François, Pascal-Moussellard Hugues, Chougar Lydia
Аннотация
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.
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.