Huge Intradural Lumbar Disc Herniation Mimicking an Intradural Spinal Tumor: A Case Report

STUDY DESIGN: A case report. OBJECTIVES: To report a case of cauda equine syndrome due to a lumbar intradural disc herniation. SUMMARY OF LITERATURE REVIEW: IDH is rare but there is a higher incidence of neurologic deficit in IDH. Therefore, it should be treated immediately. MATERIALS AND METHODS: A 34-year-old male patient was presented with cauda equina syndrome due to a lumbar intradural mass and underwent surgical excision. RESULTS: Operative findings and the histologic study revealed an intradural disc herniation. CONCLUSIONS: IDH is very rare lesion but should be considered in a differential diagnosis if preoperative MRI demonstrates an intradural lesion.

Sequestrated Intradural Disc Herniation Around Couns Medullaris: A Case Report

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of intradural disc herniation (IDH) around conus medullaris. SUMMARY OF LITERATURE REVIEW: IDH is rare with an incidence of less than 1% of all lumbar disc herniations. It is important to differentiate IDH from other condition with accurate diagnosis and subsequent surgical treatment. IDH has a higher risk of neurologic deficit, like conus medullaris syndrome and cauda equina syndrome. MATERIALS AND METHODS: A 62 year-old male was affected by lumbar back pain radiating to the anterolateral aspect of the right thigh for 5 days. MRI showed a mass that existed on the anterior portion of the conus medullaris. We performed partial laminectomy at the L1-L2level. The mass located anteriorly in the intradural space was eliminated after durotomy by a posterior approach. RESULTS: We confirmed the IDH for histopathology. CONCLUSIONS: IDH usually needs accurate differential diagnosis. Preoperative MRI scans are necessary to differentiate IDH from other intradural lesions. The confirmative diagnosis can be done only in the operative field.

Remote Cerebellar Hemorrhage after Intradural Disc Surgery

We report a rare case of remote cerebellar hemorrhage after intradural disc surgery at the L1-2 level. Two days after the spine surgery, patient complained unexpected headache, dizziness, nausea and vomiting. From the urgently conducted brain CT, it was reported that the patient had cerebellar hemorrhage. Occipital craniotomy and hematoma evacuation was performed, and hemorrhagic lesion on the right cerebellum was effectively removed. After occipital craniotomy, the patient showed signs of improvement on headache, dizziness, nausea and vomiting. He was able to leave the hospital after two weeks of initial operation without any neurological deficit. Remote cerebellar hemorrhage following spinal surgery is extremely rare, but may occur from dural damage of spinal surgery, accompanied with cerebrospinal fluid leakage. Early diagnosis is particularly important for the optimal treatment of remote cerebellar hemorrhage.

Traumatic Intradural Lumbar Disc Herniation without Bone Injury

Intradural lumbar disc herniation is a rare disease. According to the reports of intradural lumbar disc herniations, most cases have developed as a chronic degenerative disc diseases. Traumatic intradural lumbar disc herniations are even rarer. A 52-year-old man visited our emergency center with numbness in his left calf and ankle after falling accident. Initial impression by radiologic findings was a spinal subdural hematoma at the L1 level. A follow up image two weeks later, however, did not demonstrate any interval change. The patient was decided to have an operation. In operative findings, a ruptured disc particle penetrating the ventral and dorsal dura was indentified after laminectomy. It was assumed to be a traumatic outcome not a degenerative change.

Dorsal Herniation of Cauda Equina Due to Sequestrated Intradural Disc

Intradural lumbar disc herniation (ILDH) is uncommon pathology. In present report, authors present a case of ILDH associated with dorsal herniation of the cauda equina rootlets in a 30-year-old male laborer who had chronic backache since last two years. To the best of our knowledge we are reporting this for first time. Report demonstrates the natural course of ILDH.

Intradural Migration of a Sequestrated Lumbar Disc Fragment Masquerading as a Spinal Intradural Tumor

Intervertebral intradural lumbar disc herniation (ILDH) is a quite rare pathology, and isolated intradural lumbar disc herniation is even more rare. Magnetic resonance imaging (MRI) may not be able to reveal ILDHs, especially if MRI findings show an intact lumbar disc annulus and posterior longitudinal ligament. Here, we present an exceedingly rare case of an isolated IDLH that we initially misidentified as a spinal intradural tumor, in a 54-year-old man hospitalized with a 2-month history of back pain and right sciatica. Neurologic examination revealed a positive straight leg raise test on the right side, but he presented no other sensory, motor, or sphincter disturbances. A gadolinium-enhanced MRI revealed what we believed to be an intradural extramedullary tumor compressing the cauda equina leftward in the thecal sac, at the L2 vertebral level. The patient underwent total L2 laminectomy, and we extirpated the intradural mass under microscopic guidance. Histologic examination of the mass revealed a degenerated nucleus pulposus.

Intradural Disc Herniation-Transdural Excission.

Intradural disc herniation (IDH) is a rare pathology.Once such case is presented with a discusion on dignosis and management.

Intradural Disc Herniation at L5-S1 Mimicking an Intradural Extramedullary Spinal Tumor: A Case Report

Intradural lumbar disc herniation is a rare pathological entity. The pathogenesis of intradural lumbar disc herniation is not known clearly. Intradural disc herniations usually occurred at the L4-L5 levels but have also been reported at other levels. However, intradural disc herniation at L5-S1 is quite rare. There are approximately nine reports in the English literature of intraradicular disc herniation at L5-S1. We described a 61-yr-old man with suspected intradural mass at the level of L5-S1 space. The patient presented with pain in the lower back and both lower legs for 4 months and a sudden exacerbation of the symptoms for 3 days. Gadolinium-enhanced magnetic resonance imaging (MRI) demonstrated a large disc herniation at the L5-S1 level with an intradural component. L5 and S1 laminectomy was performed, and dura was swollen and immobile. Subsequent durotomy was performed and an intradural disc fragment was removed. The patient had full recovery in 3 months. Intradural lumbar disc herniation must be considered in the differential diagnosis of mass lesions in the spinal canal. Contrast-enhanced MRI scans are useful to differentiate a herniated disc from a disc space infection or tumor.

Intradural Lumbar Disc Herniation with Intradural Gas: Report of Three Cases

This paper reports on three cases of an intradural lumbar disc herniation (IDLDH) that were diagnosed by a radiological examination. In all cases, an intradural vacuum (IDV) was detected on the CT scans, and the IDLDH showed iso- or lower signal intensity on the T2-weighted images. Enhanced MRI of one case revealed a small amount of air, but this was without enhancement. All the cases showed definite IDV on the CT scans, and this was an important clue for diagnosing IDLDH.

Intradural Lumbar Disc Rupture

The intradural lumbar disc herniation which was first described by Dandy in 1942 is unusual. The pathogenesis is obscure and preoperative diagnosis is not easy. The patient usually have more severe neurologic deficits than those found in the much more common extradural disc herniations. We experienced two cases of the intradural lumbar disc herniation who had previous disc operations and the symptoms and neurologic signs were improved after removal of the intradural sequestration of disc fragments.