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Brown Sequard Syndrome

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Jongchul Chung – 1st expert on this subject based on the ideXlab platform

  • spontaneous cervical epidural hematoma causing Brown Sequard Syndrome
    Korean Journal of Spine, 2012
    Co-Authors: Byul Hee Yoon, Ki Seok Park, Sung Sam Jung, Mun Sun Park, Seungyoung Chung, Jongchul Chung

    Abstract:

    Spontaneous cervical epidural hematoma (SCEH) is a rare clinical entity and has a varied etiology. Urgent surgical decompression should be done to prevent serious permanent neurologic deficits. We describe a 59-year-old female who presented with BrownSequard Syndrome due to spontaneous cervical epidural hematoma. Initially, she was misdiagnosed as cerebrovascular accident. Cervical magnetic resonance imaging revealed epidural hematoma to the right of the spinal cord extending from C3 to C6. She later underwent surgical evacuation and had complete restoration of neurologic function. The outcome in SCEH is essentially determined by the time taken from onset of the symptom to operation. Therefore, early and precise diagnosis such as careful history taking and MRI evaluation is mandatory.

Byul Hee Yoon – 2nd expert on this subject based on the ideXlab platform

  • spontaneous cervical epidural hematoma causing Brown Sequard Syndrome
    Korean Journal of Spine, 2012
    Co-Authors: Byul Hee Yoon, Ki Seok Park, Sung Sam Jung, Mun Sun Park, Seungyoung Chung, Jongchul Chung

    Abstract:

    Spontaneous cervical epidural hematoma (SCEH) is a rare clinical entity and has a varied etiology. Urgent surgical decompression should be done to prevent serious permanent neurologic deficits. We describe a 59-year-old female who presented with BrownSequard Syndrome due to spontaneous cervical epidural hematoma. Initially, she was misdiagnosed as cerebrovascular accident. Cervical magnetic resonance imaging revealed epidural hematoma to the right of the spinal cord extending from C3 to C6. She later underwent surgical evacuation and had complete restoration of neurologic function. The outcome in SCEH is essentially determined by the time taken from onset of the symptom to operation. Therefore, early and precise diagnosis such as careful history taking and MRI evaluation is mandatory.

Manoel Jacobsen Teixeira – 3rd expert on this subject based on the ideXlab platform

  • mystery case Brown Sequard Syndrome caused by idiopathic spinal cord herniation
    Neurology, 2016
    Co-Authors: Erich Talamoni Fonoff, William Omar Contreras Lopez, Manoel Jacobsen Teixeira

    Abstract:

    A 48-year-old man developed numbness in the left leg, which progressed gradually to paresis and urinary incontinence. Neurologic examination revealed a left BrownSequard Syndrome with leg paresis, mild spasticity, reduced proprioception, and contralateral thermal and painful hypoesthesia below T6. MRI revealed a thoracic spinal cord herniation (SCH) (figure). Idiopathic SCH is relatively rare. Pathogenesis involves a dura mater defect (see video on the Neurology ® Web site at [Neurology.org][1]); herniation develops over a progressive pressure gradient through the dural fissure.2 Surgical reduction is typically performed if symptoms progress, but mild symptoms may be eligible for conservative treatment and monitoring. Surgical spinal reduction and dural repair usually reverses neurologic deficits.

    [1]: http://neurology.org/lookup/doi/10.1212/WNL.0000000000002886

  • Brown Sequard Syndrome associated with unusual spinal cord injury by a screwdriver stab wound
    International Journal of Clinical and Experimental Medicine, 2014
    Co-Authors: Andre Beerfurlan, Wellingson Silva Paiva, Wagner Malago Tavares, De Andrade Af, Manoel Jacobsen Teixeira

    Abstract:

    Introduction: Stab wounds resulting in spinal cord injuries are very rare. In direct central back stabbings, the layers of muscles and the spinal column tends to deflect blades, rarely causing injuries to the spinal cord. We report an unusual case of traumatic spinal cord injury by a screwdriver stab, presented as BrownSequard Syndrome and discuss possible pitfalls on the surgical treatment. Case report: A 34 year-old man was brought to the emergency department after a group assault with a single screwdriver stab wound on the back. Neurological examination revealed an incomplete BrownSequard Syndrome, with grade IV motor deficit on the left leg and contralateral hemihypoalgesia below T9 level. Radiological evaluation showed a retained 9 cm screwdriver that entered and trespassed the spinal canal at T6 level, reaching the posterior mediastinum with close relation to the thoracic aorta. Vascular injury could not be excluded. The joint decision between the neurosurgery and the vascular surgery teams was the surgical removal of the screwdriver under direct visualization. A left mini-thoracotomy was performed. Simultaneously, a careful dissection was done and screwdriver was firmly pulled back on the opposite path of entry under direct visualization of the aorta. The neurological deficit was maintained immediately after the surgical procedure. Follow-up visit after 1 year showed minor motor deficit and good healing. Conclusions: It is important to consider all aspects of secondary injury on the surgical planning of penetrating spinal cord injury. The secondary injury can be minimized with multidisciplinary planning of the surgical procedure.