Case Report
Extension of the preexisting intramural pouch in the ventral dura following repair for idiopathic spinal cord herniation
2022 Volume 13 Issue 7 Pages 981-986
Details
2022 Volume 13 Issue 7 Pages 981-986
Introduction: We report a rare case of ectopic cerebrospinal fluid (CSF) pooling that developed after idiopathic spinal cord herniation (ISCH) surgery.
Case Report: A 57-year-old man presented with Brown-Séquard syndrome. Magnetic resonance imaging (MRI) revealed ISCH at the T4/5 level.
Intraoperatively, we observed herniation of the spinal cord into an intramural pouch between the duplicated ventral dura mater. We released and repaired the hernia using an expanded polytetrafluoroethylene (ePTFE) sheet. The patient's symptoms worsened by the 7th month postoperatively, and MRI revealed ectopic CSF pooling at the ventral aspect of the spinal canal from the cervical to lumbar levels. During re-operation, we identified a wide cavity through the dural defect. Intraoperative findings confirmed extension of the pre-existing intramural pouch that encompassed all spinal levels.
Conclusions: Membranous adhesion secondary to an ePTFE sheet may function as a one-way valve on the pulsatile CSF and result in the aforementioned complication.
