Brown-Séquard Syndrome Secondary to Cervical Spinal Meningioma: A Case Report

Brown-Séquard syndrome (BSS) is an incomplete spinal cord injury classically caused by hemisection of the cord, resulting in ipsilateral upper motor neuron weakness and loss of proprioception, vibration, and fine touch, with contralateral loss of pain and temperature sensation. In addition, lower motor neuron signs and segmental sensory deficits may be observed at the level of the lesion. While traumatic etiologies are most commonly reported, compressive lesions such as spinal meningiomas can produce similar clinical presentations. In this case, we present a 66-year-old male with a three-month history of progressive gait difficulty who presented with classic BSS symptoms secondary to a C7 intradural extramedullary meningioma. The patient underwent successful surgical resection via C6-T1 posterior cervical laminectomy with excellent neurological recovery. Histopathological examination revealed a World Health Organization (WHO) Grade 2 atypical meningioma. At the eight-week follow-up, the patient demonstrated significant functional improvement with resolution of spasticity and motor weakness, with only mild residual sensory deficits. This case highlights the importance of recognizing progressive myelopathy symptoms and emphasizes that early surgical intervention for compressive spinal cord lesions can result in excellent functional outcomes, even in elderly patients with atypical meningioma pathology.