Cervical epidural haematoma causing Brown-Sequard syndrome: a case report
Arvind G Kulkarni1, Kushal Nag, Sambhav Shah
1Saifee Hospital, Mumbai, India.
Journal of Orthopaedic Surgery (Hong Kong)
|December 25, 2013
Summary
Brown-Sequard syndrome from spinal cord compression due to epidural hematoma after minor trauma is uncommon. Prompt surgical evacuation led to significant neurological recovery in a 65-year-old woman.
Area of Science:
- Neurology
- Neurosurgery
- Spinal Cord Injury
Background:
- Brown-Sequard syndrome, characterized by hemiplegia and contralateral anesthesia, typically results from spinal cord hemisection.
- Spinal cord compression from epidural hematoma is a rare cause of Brown-Sequard syndrome, especially after minor trauma.
Observation:
- A 65-year-old woman presented with acute neck pain, hemiplegia, and contralateral sensory loss.
- Magnetic resonance imaging revealed a C3-C5 epidural hematoma compressing the spinal cord.
Findings:
- Surgical decompression via open-door laminoplasty successfully evacuated the epidural hematoma.
- The patient experienced complete recovery of sensation and motor function (neurological grade 5/5) at the 2-year follow-up.
Implications:
- Early diagnosis and surgical intervention are crucial for favorable outcomes in spinal epidural hematomas causing Brown-Sequard syndrome.
- This case highlights the importance of considering spinal epidural hematoma in the differential diagnosis of acute neurological deficits following minor trauma.
- Timely management can reverse severe neurological deficits and improve quality of life.
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