Cervical fracture from chronic steroid usage presenting as a stroke: A case report

Area of Science:

• Neurology
• Neurosurgery
• Spinal Surgery

Background:

• Misdiagnosis of Brown-Séquard-like presentations can delay essential treatment.
• Stroke mimics, though not strokes, require prompt medical attention.
• Delayed care for stroke mimics can lead to exacerbated neurological symptoms.

Purpose of the Study:

• To discuss a rare case of Brown-Séquard syndrome caused by an occult cervical spine fracture.
• To highlight the importance of continued investigation when stroke is ruled out.
• To emphasize the need for bone density monitoring in chronic steroid users.

Main Methods:

• Case presentation of a patient with neurological deficits.
• Diagnosis of an occult cervical spine fracture with Brown-Séquard syndrome.
• Surgical intervention including anterior cervical discectomy and fusion, and laminectomy.

Main Results:

• The patient's Brown-Séquard syndrome resolved after surgical treatment.
• The case underscores the risks associated with delayed diagnosis and treatment.
• Highlights the potential for severe outcomes from seemingly less urgent conditions.

Conclusions:

• Patients on chronic steroids require monitoring for low bone density and potential osteoporotic symptoms.
• Continued diagnostic investigation is vital even after ruling out stroke.
• Stroke mimics warrant the same diagnostic urgency as strokes.