{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T06:40:37Z","timestamp":1764225637129,"version":"3.46.0"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"\n Background<\/jats:title>\n Cervical intradural disc herniation (CIDH) is a rare spinal condition characterized by herniation of nucleus pulposus through the dura mater into the subarachnoid space, resulting in spinal cord or nerve root compression. Its rarity and nonspecific imaging features make preoperative diagnosis particularly challenging.<\/jats:p>\n <\/jats:sec>\n \n Case presentation<\/jats:title>\n We report a 55-year-old man with sudden-onset left-sided limb weakness and inability to walk, without prior trauma. Neurological examination revealed Brown-S\u00e9quard syndrome, with ipsilateral motor deficits and contralateral sensory loss. Sagittal T2-weighted MRI demonstrated marked hyperintensity at the C4\/5 intervertebral disc compared to adjacent levels. Intraoperatively, the disc material exhibited visibly increased water content compared to typically desiccated degenerative discs. A small amount of clear fluid was noted near the posterior longitudinal ligament. Further exploration revealed a ventral dural tear with herniated disc fragments within the subarachnoid space, confirmed histologically as CIDH. The patient underwent anterior cervical corpectomy and fusion with dural repair, resulting in neurological recovery. At one-year follow-up, only mild residual weakness in the left hand remained.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This case underscores T2 hyperintensity and intraoperative detection of disc tissue with increased water content as potential indicators of CIDH in acute cervical myelopathy. Recognizing these features may support earlier diagnosis, guide surgical planning, and reduce complications such as cerebrospinal fluid leakage.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1653174","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T06:30:06Z","timestamp":1764225006000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cervical intradural disc herniation: a new diagnostic clue based on MRI T2 hyperintensity and intraoperative increased water content in the intervertebral disc\u2014a case report and mechanistic insights"],"prefix":"10.3389","volume":"12","author":[{"given":"Guodong","family":"Guo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohui","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daokuan","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huijuan","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"B1","first-page":"396","article-title":"Intradural disc herniations in the cervical, thoracic, and lumbar spine: report of three cases and review of the literature","volume":"3","author":"Epstein","year":"1990","journal-title":"J Spinal Disord"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jocn.2017.10.024","article-title":"Cervical intradural disc herniation: a systematic review","volume":"48","author":"Guan","year":"2018","journal-title":"J Clin Neurosci"},{"key":"B3","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.wneu.2017.09.209","article-title":"Clinical presentation, diagnosis, and surgical treatment of spontaneous cervical intradural disc herniations: a review of the literature","volume":"109","author":"Gunasekaran","year":"2018","journal-title":"World Neurosurg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"28","DOI":"10.21037\/acr-22-82","article-title":"Intradural cervical herniated nucleus pulposus presentation and management: a case report","volume":"7","author":"Yen","year":"2023","journal-title":"AME Case Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2403","DOI":"10.2147\/JPR.S200632","article-title":"Cervical intradural disc herniation with Brown-S\u00e9quard syndrome: case report and literature review","volume":"12","author":"Rong","year":"2019","journal-title":"J Pain Res"},{"key":"B6","first-page":"221","article-title":"Intradural cervical disc herniation. 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A report of two cases","volume":"7","author":"Choi","year":"2007","journal-title":"Spine J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/s1529-9430(03)00078-0","article-title":"Brown-S\u00e8quard syndrome produced by cervical disc herniation: report of two cases and review of the literature","volume":"3","author":"Kobayashi","year":"2003","journal-title":"Spine J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e2797","DOI":"10.1097\/MD.0000000000002797","article-title":"Cervical intradural disc herniation causing progressive quadriparesis after spinal manipulation therapy: a case report and literature review","volume":"95","author":"Yang","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"86","DOI":"10.4103\/joss.joss_37_22","article-title":"Spontaneous cervical intradural disc herniation with cerebrospinal fluid leak","volume":"10","author":"Nathan","year":"2023","journal-title":"J Spinal Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1016\/j.radcr.2019.06.004","article-title":"Cervical intradural disc herniation, case report and reflection on preoperative imaging","volume":"14","author":"Celano","year":"2019","journal-title":"Radiol Case Rep"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1653174\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T06:30:07Z","timestamp":1764225007000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1653174\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,27]]},"references-count":12,"alternative-id":["10.3389\/fsurg.2025.1653174"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1653174","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,27]]},"article-number":"1653174"}}