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Traumatic Brown-Séquard-plus syndrome
M O McCarron1, P A Flynn, K A Pang
1Department of Neurology, Quin House, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland. mark.mccarron@royalhospitals.n-i.nhs.uk
Archives of Neurology
|September 18, 2001
Summary
A penetrating neck injury caused a rare Brown-Séquard-plus syndrome in a young man. He experienced significant neurological deficits but recovered well with normal mobility and bladder function.
Area of Science:
- Neurology
- Neurosurgery
- Trauma Surgery
Background:
- Brown-Séquard syndrome, first described in the 1840s, results from hemisection of the spinal cord, affecting motor and sensory pathways.
- Penetrating injuries to the spinal cord can lead to Brown-Séquard syndrome or the more complex Brown-Séquard-plus syndrome.
Observation:
- A 25-year-old man sustained a stab wound to the right neck, resulting in left-sided Brown-Séquard syndrome at the C8 level.
- The patient also presented with left-sided Horner syndrome, urinary retention, and bilateral extensor responses.
Findings:
- Magnetic resonance imaging revealed a lesion in the lower cervical spinal cord.
- Somatosensory evoked potentials confirmed a disturbance in the left dorsal column, consistent with the clinical presentation.
- The patient demonstrated a positive recovery, with significant improvement in mobility and bladder function.
Implications:
- This case highlights the potential for recovery from severe spinal cord injury following penetrating trauma.
- The Brown-Séquard-plus syndrome, involving deficits beyond a typical Brown-Séquard presentation, can be successfully managed.
- Early diagnosis and appropriate management are crucial for optimizing outcomes in patients with penetrating spinal cord injuries.