You are here

Article Text

Article menu

Download PDFPDF

XML
Unusual presentation of more common disease/injury
CASE REPORT
Intradural lumbar disc herniation detected by 3D CISS MRI
  1. Laurence Crivelli,
  2. Vincent Dunet
  1. Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
  1. Correspondence to Laurence Crivelli, laurence.crivelli{at}chuv.ch

Summary

A 73-year-old man who presented with right lumbosciatic pain underwent a neurosurgical operation for a voluminous L2–L3 disc herniation, seen on conventional MRI images. No disc herniation was identified in the epidural space during the surgery. Just after the operation, the patient started to present pain in the left L3 territory and was not able to walk any more. A second MRI including three-dimensional (3D) high-resolution constructive interference in steady state (CISS) sequence showed that the voluminous L2–L3 disc split the posterior longitudinal ligament and the anterior dura mater, extended intradurally and compressed the cauda equina to the right. The patient underwent a second surgery, which permitted to cure the symptoms. 3D high-resolution CISS should be considered to accurately depict intradural disc herniation in order to optimally guide the surgical approach.

  • radiology
  • neurosurgery
  • neuroimaging

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bcr-2017-221728

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors Both authors significantly contributed to this work, read and approved the final version, did a literature review about the subject and wrote the case report. LC wrote about the disease part in the first draft. VD wrote about the MRI technical part. Both authors commented and added corrections to the entire case report in the following drafts and accepted the final version.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.