Introduction: Transdural spinal cord herniation is a protrusion of the spinal cord through a dehiscence of the dura mater. It generally occurs in the thoracic region (between T4 and T7). It may be idiopathic or secondary (traumatic or iatrogenic). Diagnosis, which is always made by MRI, is often delayed. Observation: This was a 45-year-old patient with a history of a traffic accident. He was consulted 14 months later for gait disorders that had been evolving for 6 months, with progressive worsening and pain in the left leg. His clinical examination revealed Brown-Séquard syndrome and sphincter disorders. MRI revealed angulation of the medulla at T7-T8 and enlargement of the posterior subarachnoid spaces. Surgical management consisted of spinal cord release with dural plasty. Progress was favorable. Conclusion: Transdural medullary herniation is a rare pathology. It is diagnosed by T2 sagittal magnetic resonance imaging. Surgical treatment is indicated for symptomatic forms. The risk of postoperative syringomyelia requires long-term monitoring.
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