Abstract
Idiopathic spinal cord herniation is very rare, 5 cases being so far reported in the literature. A 71-year-old-woman with a gradual loss of power in her left leg and with a sensory disturbance in the lateral side of her right leg was admmited. MRI showed that from Th4 to Th5, the spinal cord was shifted ventrally and disappeared, and a dilated subarachnoid space was noticed dorsally. She was diagnosed spinal cord herniation associated with an arachnoid cyst, and the operation was done. During operation, not only an intradural arachnoid cyst was obsreved dorsally, but was duplicated dura mater ventrally. In the ventral lesion, the spinal cord was herniated through a defect of the inner layer of the dura mater. This dural inner layer as well as the arachnoid cyst was resected. Her clinical symptoms were not progressed.When the spinal cord is shifted or disappeared in an image, we should precisely determine the relationship between the spinal cord and the dura mater during operation with consideration of a possibility of the presence of idiopathic spinal cord herniation.
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