Blunt cervical spine Brown-Séquard injury. A report of three cases

Cervical spinal cord Brown-Séquard syndrome was diagnosed in three recent victims of blunt injury at the authors' Level II Trauma Center. While anatomic hemisection of the cord, resulting in ipsilateral motor and proprioception loss and contralateral pain and temperature deficit, is a fully understandable concept, in the context of the acute trauma evaluation, these findings may be confusing because they are unexpected. Penetrating trauma is far more likely to cause this uncommon syndrome than vehicular crash, fall, or crushing injury. Pediatric victims frequently have no fracture. Early neurosurgical consultation, computed tomography (CT), and magnetic resonance imaging (MRI) if plain film radiography is uninformative, and consideration for rapid decompression if the deficit and pathologic anatomy warrant, are the recommended approaches. Motor function recovery from blunt injury may be expected within six months, a better prognosis than for penetrating injury causing the syndrome.