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KMID : 0948920170160010031
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Clinical Pain
2017 Volume.16 No. 1 p.31 ~ p.35
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Lumbosacral Radiculopathy Caused by Adult Tethered Cord Syndrome with Underlying Traumatic Brain Injury - A Case Report -
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Jang Chang-Woong
Kim Jong-Moon
Kim Hyoung-Seop
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Abstract
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Adult tethered cord syndrome (ATCS) is a rare entity and which symptoms mimic a wide spectrum of pathologies, making diagnosis of ATCS a truly demanding task. We present a 24-year-old man with ATCS who had suffered a traumatic brain injury (TBI). In order to provide relief on the hydrocephalus, ventriculoperitoneal shunts (VP shunt) were inserted at both sides with pressure adjusted several times throughout the day. He complained of persistent gait disturbance, lower extremities weakness and newly developed, lower back pain. Mini mental status examination showed no significant change and laboratory tests werewithin normal limits. Computed tomography (CT) scan did not reveal any signs of aggravation of the hydrocephalus and shunt malfunction. Electrodiagnostic test revealed lumbosacralradiculopathy, mainly at L5 or S1. However, a lumbar spine magnetic resonance imaging (MRI) showed a tethered cord at the level of S1. We, therefore, recommended him to have detethering surgery. This is a complicated case report on combined ATCS and TBI.
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KEYWORD
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Tethered cord syndrome, Radiculopathy, Traumatic brain injury
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