Spontaneous herniation of the spinal cord as a cause of progressive Brown-Sequard's syndrome. A report of 3 cases

Spontaneous hemiation of the spinal cord through a ventral dural defect is a rare neurological entity. We report an 3 patients treated in our clinic w ithin 6 months. In 2 cases, the lesions were located at the BWK6 level and, in one case,at BWK2. The clinical presentation of all patients was f progre ssive Brown-Sequard's Syndrome. Diagnosis was confirmed by magnetic resonan ce imaging. In all cases,operation was performed. The myelon was replaced i n the dural sleeve and the defect covered with a patch of lyophilized dura. After 1 year,symptoms were stable in 2 patients. In one case there was a s light deterioration because of an inexplicable swelling of the spinal cord which could not be controlled with a second operation. Pathophysiological, clinical, and radiological aspects are presented and discussed.