====== Cervical disc herniation clinical features ======

===== Cervical radiculopathy =====
see [[Cervical radiculopathy clinical features]]

The most common scenerio of [[cervical disc herniation]] is that the [[symptom]]s were present upon awakening in the morning without identifiable trauma or stress
((Mayfield FH. Cervical spondylosis: a comparison of the anterior and posterior 
approaches. Clin Neurosurg. 1965;13:181-8. PubMed PMID: 5870806.
)).

[[Cervical radicular pain]]: The [[cervical disc]]s are not very large; however, there is also not a lot of space available for the nerves. This means that even a small cervical disc herniation may impinge on the nerve and cause significant pain. The [[arm pain]] is usually most severe as the nerve first becomes pinched.

===== Cervical myelopathy =====

[[Degenerative cervical myelopathy]] and [[SCI]] due to [[cervical disc herniation]]:

Acute cord compression presenting with myelopathy or spinal cord injury, especially [[central cord syndrome]] and sometimes [[Brown Sequard syndrome]] is well described in association with [[traumatic cervical disc herniation]]
((Dai L, Jia L. Central cord injury complicating acute cervical disc herniation in trauma. Spine (Phila Pa 1976). 2000 Feb 1;25(3):331-5; discussion 336. PubMed PMID: 10703105.)).

Less commonly, these findings may occur in non traumatic [[cervical disc herniation]].

This presentation of cervical disc herniation with accurate diagnosis, and early anterior spinal cord decompression lead to complete recovery of these cases
((Abouhashem S, Ammar M, Barakat M, Abdelhameed E. Management of Brown-Sequard
syndrome in cervical disc diseases. Turk Neurosurg. 2013;23(4):470-5. doi:
10.5137/1019-5149.JTN.7433-12.0. PubMed PMID: 24101266.
)).

Kobayashi et al. reported reported in [[2003]] two cases of Brown-Sèquard syndrome produced by herniated cervical disc.

The first patient was a 64-year-old man who presented with right leg weakness and diminished sensation to pain and temperature in the left side below the T4 dermatome. The second patient was a 39-year-old man who presented with right-sided weakness and diminished sensation to pain and temperature in the left side below the T6 dermatome.

Anterior cervical discectomy with fusion was performed for these patients.

These cases revealed contralateral deficit in sensation of pain and temperature of more than a few levels below the cord compression, and showed paracentral protruded disc in magnetic resonance images and cervical spinal stenosis in cervical spine X-rays. Postoperatively, motor and sensory function of these patients returned to normal.

Characteristic finding in discogenic Brown-Sèquard syndrome are contralateral deficit in sensation of pain and temperature of more below than a few levels below the cord compression and paracentral protruded disc with cervical spinal stenosis. Outcomes are favorable in rapid diagnosis by magnetic resonance images and performance of anterior approach
((Kobayashi N, Asamoto S, Doi H, Sugiyama H. Brown-Sèquard syndrome produced by 
cervical disc herniation: report of two cases and review of the literature. Spine
J. 2003 Nov-Dec;3(6):530-3. Review. PubMed PMID: 14609700.
)).
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In 1983, Heyl associated Brachioradial pruritus (BP) with cervical spine disorders such as osteoarthritis, trauma or disc herniations
((Heyl T. Brachioradial pruritus. Arch Dermatol. 1983;119:115–116.)).