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首页> 外文期刊>The Internet Journal of Neurology >Images In Neurology: Spinal Cord Herniation In A Patient With Brown Sequard Syndrome
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Images In Neurology: Spinal Cord Herniation In A Patient With Brown Sequard Syndrome

机译：神经病学中的图像：布朗Sequard综合征患者的脊髓疝。

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A 44-year-old female patient was alright till two years back when she noticed insidious onset of decreased pain sensation of the whole of right lower limb. She did not have any motor weakness, back ache, bladder symptoms or altered gait at that time. Magnetic resonance imaging (MRI) of the spinal cord at this time was interpreted as disc herniation in the cervical region and she was managed conservatively. Over the next 2 years she developed gradually progressive weakness of the distal muscles of the left lower limb and later involving proximal muscles. This was followed by urgency of micturition, with preserved bladder sensations. She was subsequently investigated with an MRI that revealed a thoracic spinal cord herniation Case Report A 44-year-old female patient was alright till two years back when she noticed insidious onset of decreased pain sensation of the whole of right lower limb. She did not have any motor weakness, back ache, bladder symptoms or altered gait at that time. Magnetic resonance imaging (MRI) of the spinal cord at this time was interpreted as disc herniation in the cervical region and she was managed conservatively. Over the next 2 years she developed gradually progressive weakness of the distal muscles of the left lower limb and later involving proximal muscles. This was followed by urgency of micturition, with preserved bladder sensations. Her past history was unremarkable except for hypothyroidism for which she was on treatment. Neurological examination revealed scoliosis of the lower dorsal and lumbar spine. There were signs of pyramidal dysfunction in the left lower limb in the form of spasticity, brisk reflexes and extensor plantar response, in addition to motor power of grade 4/5 distally and proximally. Vibration sense was impaired on left side till D10 level and position sense was impaired in the left foot. There was a 50% impairment of pain and temperature was on the right side till D4 spinal segmental level. There was no pain, tenderness or gibbus deformity of the spine. Other systemic examinations were normal. Laboratory investigations showed normal blood counts, ESR and serum biochemistry. She was subsequently investigated with an MRI (Fig 1 & 2) that revealed a thoracic spinal cord herniation
机译：一名44岁的女性患者病情好转，直到两年前，她注意到隐匿性发作，导致右下肢整体疼痛感降低。那时她没有任何运动无力，腰酸，膀胱症状或步态改变。此时的脊髓磁共振成像（MRI）被解释为颈椎间盘突出症，并且保守治疗。在接下来的2年中，她逐渐发展为左下肢的远端肌无力，随后逐渐累及近端肌。其次是尿急和膀胱感觉保留。随后她接受了MRI检查，发现胸部脊髓疝。病例报告一名44岁的女性患者还不错，直到两年前，她注意到隐匿性发作，导致右下肢疼痛感降低。那时她没有任何运动无力，腰酸，膀胱症状或步态改变。此时的脊髓磁共振成像（MRI）被解释为颈椎间盘突出症，并且保守治疗。在接下来的2年中，她逐渐发展为左下肢的远端肌无力，随后逐渐累及近端肌。其次是尿急和膀胱感觉保留。除了过去接受治疗的甲状腺功能减退症外，她过去的病史并不多见。神经系统检查显示下背和腰椎脊柱侧弯。除远端和近端的4/5级运动能力外，左下肢还存在着锥体束功能障碍的迹象，表现为痉挛，轻快反射和伸肌足底反应。直到D10为止，左侧的振动感减弱，左脚的位置感减弱。直至D4脊柱节段水平，右侧疼痛和痛觉均降低了50％。脊柱没有疼痛，压痛或吉布斯畸形。其他全身检查均正常。实验室检查显示血常规，ESR和血清生化指标正常。随后，她接受了MRI检查（图1和2），发现胸部脊髓疝

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