Acute Cervical Disk Herniation Resulting in Sudden and Severe Neurologic Deterioration: A Case Series
| Autor: | Nachshon Knoller, Ran Harel |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Brown-Séquard syndrome brown-séquard syndrome Decompression lcsh:Surgery macromolecular substances acute cervical herniated disk 03 medical and health sciences 0302 clinical medicine Informed consent medicine Neurologic deterioration 030212 general & internal medicine cervical myelopathy medicine.diagnostic_test business.industry Magnetic resonance imaging lcsh:RD1-811 medicine.disease Institutional review board Surgery acute neurologic deterioration anterior cervical approach Functional status Presentation (obstetrics) business 030217 neurology & neurosurgery |
| Zdroj: | The Surgery Journal, Vol 02, Iss 03, Pp e96-e101 (2016) |
| ISSN: | 2378-5136 2378-5128 |
| DOI: | 10.1055/s-0036-1593357 |
| Popis: | Objective Nontraumatic acute cervical disk herniation resulting in acute severe neurologic deficit is a rare entity described in a limited number of case reports. We describe the management and outcome in patients presenting with severe neurologic deterioration caused by acutely herniated cervical disks. Methods Four patients (mean age 39.5 years) presented to our tertiary care academic medical center from September 2012 to September 2013 with severe progressive neurologic deficits due to cervical disk herniation and were included in the series. Patients' surgical, medical, and imaging records were retrospectively reviewed under an Institutional Review Board waiver of informed consent. Results Patients in the series presented with acute neurologic deterioration, including paraparesis, Brown-Séquard syndrome, or quadriparesis deteriorating to quadriplegia. Emergent magnetic resonance imaging (MRI) scans and emergent decompression and fusion for acute soft disk herniation were performed in all cases. All patients recovered to excellent functional status with Frankel score improvement from B (one patient)/C (three patients) to E (three patients)/D (one patient). Conclusions Acute cervical disk herniation with acute neurologic deterioration is a medical emergency necessitating emergent MRI and surgical decompression. Clinical presentation varies. In patients with rapid-onset neurologic deterioration, a high level of suspicion for this rare entity is indicated. |
| Databáze: | OpenAIRE |
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