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Sudden nontraumatic tetraplegia associated with cervical disc herniation: Case report Andrej Porčnik Borut Prestor University Medical center Ljubljana,

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Presentation on theme: "Sudden nontraumatic tetraplegia associated with cervical disc herniation: Case report Andrej Porčnik Borut Prestor University Medical center Ljubljana,"— Presentation transcript:

1 Sudden nontraumatic tetraplegia associated with cervical disc herniation: Case report Andrej Porčnik Borut Prestor University Medical center Ljubljana, Slovenia

2 Background Cervical disc herniation is a rare cause of nontraumatic para- or tetraplegia and as such represents a true emergency. We present a case of acute nontraumatic tetraplegia secondary to cervical disc herniation with no associated previous spinal stenosis or previous signs of mielopathy. The pathophisiology of acute tetraplegia and need for urgent surgical decompression is presented. 1st Congress of Southeast European Neurosurgical Society - SEENS2

3 Case report A 37-year old men presented with sudden onset of muscle weakness in the arms and legs that quickly progressed. He had no history of head and neck trauma. The clinical picture was in accordance with the anterior spinal cord syndrome – he finally developed acute C6 tetraplegia. 1st Congress of Southeast European Neurosurgical Society - SEENS3

4 Case report Sagittal T2-weighted (A) and T1-weighted (B) magnetic resonance images show a posteriorly protruding disc C5-C6 (arrowhead). There is increased signal intensity (arrow) in the spinal cord at the level of the C5-C6 disc (B). Axial T2-weighted (C) magnetic resonance image shows that the cervical cord is compressed at the level of the C5-C6 disc. 1st Congress of Southeast European Neurosurgical Society - SEENS4

5 Case report - operation Microdiscectomy C5-C6 was performed. His neurological condition improved during few days after the operation. Clinical picture was fully reversible C6 tetraplegia. During the six year postoperative observation period he stayed symptom free. 1st Congress of Southeast European Neurosurgical Society - SEENS5

6 Case report Magnetic resonance imaging two years after the operation (A, B, C) showing decompression of the spinal cord at the level of the C5-C6 disc (arrowhead). On T2- weighted image (B) high signal intensity remained at the C5-C6 level in the central portion of the cervical spinal cord (arrow). 1st Congress of Southeast European Neurosurgical Society - SEENS6

7 Conclusion Cervical disc herniation should be considered in the differential diagnosis of acute nontraumatic para- or tetraplegia. Cervical herniation can cause diminished blood supply to the anterior spinal artery and anterior spinal cord ischaemia. Immediate magnetic resonance imaging and early decompressive surgery is recommended to avoid irreversible neurologic deficit. Andrej Porčnik Borut Prestor University Medical center Ljubljana, Slovenia 1st Congress of Southeast European Neurosurgical Society - SEENS7


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