gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Surgical management of Brown-Séquard syndrome caused by idiopathic spinal cord herniation

Chirurgische Therapie des Brown-Sequard Syndroms im Falle einer ideopathischen Rückenmarks-Herniation

Meeting Abstract

  • corresponding author B. Fischer - Klinik für Neurochirurgie, Universtitätsklinikum Münster
  • C. Schul - Klinik für Neurochirurgie, Universtitätsklinikum Münster
  • T. Elger - Klinik und Poliklinik für Neurologie, Universtitätsklinikum Münster
  • W. Heindel - Institut für Klinische Radiologie, Universitätsklinikum Münster
  • H. Wassmann - Klinik für Neurochirurgie, Universtitätsklinikum Münster

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP101

The electronic version of this article is the complete one and can be found online at:

Published: May 4, 2005

© 2005 Fischer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




During the last 30 years, 40 cases of surgically treatable Brown-Séquard syndrome caused by spontaneous herniated spinal cord were reported. In contrast to posttraumatic cases, there is no real explanation for the pathogenesis of these cases.

We reported here another case of a 59-year-old woman with idiopathic herniated spinal cord, her clinical symptoms and the success of surgical intervention.


A 59-year-old woman was admitted 2.5 years after the onset of right-sided paraesthesia from dermatome T7/8 downwards. Half a year ago,dysaesthesias of the right and weakness of the left lower limb occurred. Furthermore she reported nocturia. Due to interpersonal conflicts and slight psychiatric problems, one assumed the symptoms to be of psychiatric origin. At the time of admission, she was found to have a Brown-Séquard syndrome with thermhypaesthesia, hypaesthesia and paraesthesia of the right lower limb and spastic paresis of the left leg. Radiological examination (CT, MRI) of the thoracic spine revealed an atrophic spinal cord affixed to the vertebral body of T2, assuming an idiopathic spinal cord herniation.

Surgical intervention was performed to detach the spinal cord from vertebral body via posterior approach. After left-sided hemilaminectomy of T2 and T3, a third dural layer could be detected with the herniated myelon.


The area of herniation could be resected completely. Immediately after surgery, the strength and mobility of the left leg started to improve. The par- and dysaesthesias of the right leg also disappeared.


The idiopathic spinal cord herniation is a rare cause for a Brown-Séquard syndrome. Although the time from the onset of symptoms to microsurgical intervention was very long, surgery can stop progress of symptoms or improve neurological deficits as demonstrated in our case.