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Images in Neurology |

The Saddle and the Horse’s Tail Cauda Equina Syndrome

Tom Theys, MD, PhD1; Kuan H. Kho, MD1,2
[+] Author Affiliations
1Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
2Department of Neurosurgery, Medisch Spectrum Twente, Enschede, the Netherlands
JAMA Neurol. 2014;71(7):914-915. doi:10.1001/jamaneurol.2013.6008.
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The cauda equina syndrome is a clinical diagnosis usually requiring immediate surgical treatment to prevent long-lasting neurological sequelae. A 33-year-old woman with a 2-week history of left-sided leg pain and perianal hypoesthesia was referred to us when urinary retention and fecal incontinence developed. The clinical diagnosis of cauda equina syndrome was made. Imaging revealed an intraspinal mass filling up the entire spinal canal at the L5-S1 level (Figure 1).

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Figure 1.
Sagittal Magnetic Resonance Imaging (A) and Computed Tomographic (B) Scans of the Lumbar Spine

Obliteration of the spinal canal due to L5-S1 disc herniation.

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Figure 2.
Herniated Nucleus Pulposus
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