A previously fit 20 year old man developed an extradural haematoma in his cervical spinal canal after an episode of disco dancing and head banging. Central cord syndrome, anterior cord syndrome, posterior cord syndrome, and brownsequard syndrome are the most common types of incomplete spinal cord syndromes. Place in the sage colleges library collection and reproduce for interlibrary loan. Brown sequard syndrome is a set of symptoms associated with a certain type of spinal cord injury. We report a case of brownsequard syndrome bss caused by an accidental stab injury of the cervical spine that shows clear magnetic resonance imaging mri findings and clinical presentation. Brownsequard syndrome anatomical basis epomedicine. Brownsequard syndrome also known as brownsequards hemiplegia, brownsequards paralysis, hemiparaplegic syndrome, hemiplegia et hemiparaplegia spinalis, or spinal hemiparaplegia is caused by damage to one half of the spinal cord, i. The terms brownsequard syndrome returned 28 free, fulltext research articles. Also we report the rare occurrence of a blunt injury to the cervical spine causing a brown sequard syndrome with associated horners syndrome, without localising symptoms or signs in the neck. The patient responded well to intravenous steroids and physical therapy. But most often it is seen in textbooks and in med school exams.
Brown sequard syndrome an overview sciencedirect topics. May 23, 2020 brown sequard syndrome is a relatively rare type of partial paralysis sometimes also referred to as brown sequard hemiplegia or brown sequard paralysis. An emergency head computed tomographic scan showed no. Brown sequard syndrome results from a transverse hemisection of the spinal cord, whereby half of the spinal cord is damaged laterally sullivan 1989. A case of brownsequard syndrome with associated horners. Acute brownsequard syndrome neurology jama neurology. Register for a free account existing user log in existing user log in. It was first described in the 1840s by dr charlesedouard brownsequard 181794. This article reports a case of brown sequard syndrome that occurred in a patient following the administration of trivalent influenza vaccine. Most neurologists will know about the brownsequard syndrome, comprising an ipsilateral. In recent years the name of brownsequard has been assigned to syndromes caused by spinal cord damage differing widely in extension.
Brownsequard syndrome after blunt cervical spine trauma. Registered users can save articles, searches, and manage email alerts. Two years later, george murray presented his ideas on the treatment of. Eduard brown sequard in 1850 as ipsilateral upper motor neuron motor weakness below. Brownsequard syndrome occurs due to lateral hemisection of the spinal cord unilateral involvement of the dorsal column, corticospinal tract, and spinothalamic tract causes of spinal cord hemisection include penetrating trauma from a stab, bullet, or fracturedisclocation, spinal cord tumor, disc herniation, syringomyelia, or hematomyelia.
Part i explores basic techniques to researching brown sequard syndrome e. Brown sequard syndrome is an incomplete spinal cord lesion characterized by a clinical picture reflecting hemisection injury of the spinal cord, often in the cervical cord region. Brown sequard syndrome nervous system neuroanatomy. She had no speech difficulty, facial weakness, or neck pain.
Brownsequard syndrome bss is a rare neurological condition characterized by a lesion in the spinal cord which results in weakness or paralysis hemiparaplegia on one side of the body and a loss of sensation hemianesthesia on the opposite side. Nov 24, 2014 brownsequards syndrome results from a lesion in one lateral half of the spinal cord for example, hemisection or lateral injury of the cord. If the syndrome develops due to some knife injury or a gunshot, other serious conditions such as organ damage or bleeding may crop up. Brownsequard syndrome a neurological disorder, caused by compression of one side of the spinal cord in the lower back, featuring paralysis on the injured side and loss of sensation on the other side. Ellie franges is a nurse practitioner in neurosurgery at st.
More detailed information regarding treatment for brownsequard syndrome can be accessed through medscape reference. Brown sequard syndrome is a rare disorder that affects males and females in equal numbers. Treatment may involve drugs that control muscle symptoms, and there is. Brownsequard syndrome is a rare form of incomplete spinal cord injury.
Brown sequard syndrome happens when there is an injury to one side of the spinal. The incidence of brownsequard syndrome has been estimated to be 2% of all traumatic spinal cord injuries. Obtain spine team consultation given concern for brownsequard syndrome bss. Brown sequard syndrome nord national organization for rare. Patients with brown sequard syndrome suffer from ipsilateral upper motor neuron paralysis and loss of proprioception, as well as contralateral loss of pain and temperature sensation. He qualified in 1846 by defending his thesis on physiology of the spinal cord.
A rare case of brownsequard syndrome caused by traumatic. Brownsequard syndrome bss is manifested as ipsilateral motor deficit and contralateral sensory loss. It is possible for edema, or swelling, to cause stress to the nerves. You may need to register to view the medical textbook, but registration is free. Cervical disc herniation causing brownsequard syndrome. Brown sequard syndrome nord national organization for. Bss may be caused by a spinal cord tumor, trauma such as a puncture wound to the neck or back, ischemia obstruction of a blood vessel, or. Ipsilateral flaccid paralysis at the level of the lesion. Charlesedouard brownsequard wrote his first publication on this finding. Brownsequard syndrome is a rare disorder that affects males and females in equal numbers. Feb 01, 2017 brown sequard syndrome most commonly occurs in the the thoracic spine upper and middle back. Traumatic brownsequardplus syndrome emergency medicine. The following day he complained of neck pain, and 36 hours after this, he presented to hospital complaining of weakness of his left arm and leg with sensory loss in his. Jun 09, 2019 famous victorian scientist, charlesedouard brownsequard, explained a rare spinal cord injury known as brownsequards syndrome bss in 1849.
The brownsequard syndrome revisited by brownsequard. Ipsilateral loss of all sensory modalities at the level of the lesion. Spinal cords and central nervous systems are incredibly complex and an injury in any particular part of the spine can lead to different outcomes for different people. Cardiovascular responses to static exercise in patients with brownsequard syndrome. The physical signs of classic brownseuard syndrome are shown in figure 2. Pdf management of brownsequard syndrome in cervical disc. Bss may be caused by a spinal cord tumor, trauma such as a puncture wound to the neck or back. Brown sequard syndrome bss is a rare neurological condition characterized by a lesion in the spinal cord which results in weakness or paralysis hemiparaplegia on one side of the body and a loss of sensation hemianesthesia on the opposite side. Incomplete spinal cord syndromes are caused by lesions of the ascending or descending spinal tracts that result from trauma, spinal compression, or occlusion of spinal arteries. Brownsequard syndrome jackson injury lawyers coxwell. Brownsequard syndrome is an incomplete spinal cord lesion. Sign up for your free online subscription to world neurology. Brownsequard syndrome usually follows spinal cord hemisection as a result of penetrating trauma, but can also occur with large disc herniation or spinal epidural hematoma.
Syndrom associerat med halvsidig ryggmargsskada, med foljande kliniska kannetecken belagna under skadestallet. Brownsequard syndrome is a rare spinal disorder that results from an injury to. Brownsequard syndrome brownsequards syndrom svensk definition. Brownsequard syndrome results from an injury to one half of the spinal cord as seen in. It is characterized by an ipsilateral weakness damage to corticospinal tracts and contralateral loss of pain and temperature two levels below the lesion damage to lateral spinothalamic tracts. The annual incidence of all forms of spinal cord injury is estimated to be 3040 per 1,000,000 people. Brownsequard syndrome as a first presentation of multiple sclerosis. Apr 27, 2018 the motor nerves that send axons down from the brain are also affected in brown sequard syndrome.
Brown sequard syndrome is a rare presentation of cervical disc herniation but. Brown s syndrome is a rare form of strabismus characterized by limited elevation of the affected eye. There is an ipsilateral loss of motor control since the motor information decussates higher at the level of the brainstem. The very basis of the brownsequard syndrome was challenged in 1892 by frederick mott, a young british neurologist who later achieved fame by establishing that general paralysis of the insane is due to syphilis and by helping to found the maudsley hospital for the mentally ill in london.
Brown sequard syndrome everything you need to know dr. Brown sequard syndrome brown sequards syndrom svensk definition. Brownsequard syndrome causes, symptoms, diagnosis, treatment. Find out about this uncommon condition and how to care for your patient. Brownsequard syndrome definition of brownsequard syndrome. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Brown sequard syndrome spinal cord injury spinal cord. Conclusion this patient recovered well after a penetrating neck injury that disturbed function in more than half the lower cervical spinal cord brownsequardplus. Lukes hospital and health network in bethlehem, pa. The disorder may be congenital existing at or before birth, or acquired. To access free multiple choice questions on this topic, click here.
Brownsequard syndrome bss consists of asymmetric paresis with hypalgesia more marked on the less paretic side. The treatment for individuals with bss depends on the cause and is focused on. It is characterized by a characteristic pattern of motor and sensory deficits that are determined by the decussation pattern of various white matter tracts. Rehabilitation of a patient with symptoms of brown. There are several causes of brown sequard syndrome, including. Also know as lateral cord syndrome, this type of spinal cord injury results from an incomplete transection of the cord. Pdf on feb 1, 2018, eliza moskowitz and others published brownsequard syndrome find, read and cite all the research you need on researchgate. Brown sequard syndrome causes, symptoms, diagnosis and. Brownsequard syndrome and networks world neurology. The injury produces a unique constellation of findings.
Brownsequard syndrome, also known as hemicord syndrome, is the result of damage to, or impairment of, the left or right side of the spinal cord. Syndrome sgd kub5 introduction brown squard syndrome is a rare spinal disorder that results from an injury to one side of the spinal cord in which the spinal cord is damaged but is not severed completely. Acute myelitis with brownsequard syndrome complicated with subjective sudomotor laterality and ileocecal abscess without right abdominal pain. Incomplete spinal cord syndromes knowledge for medical. Urinary dysfunction in browns quard syndrome request pdf. Brown sequard syndrome is an incomplete pattern of injury showing a hemisection of the spinal cord. The incidence of brown sequard syndrome has been estimated to be 2% of all traumatic spinal cord injuries. It is usually caused by an injury to the spine in the region of the neck or back characteristically, the affected person loses the sense of touch, vibrations and position in. It is usually caused by an injury to the spine in the region of the neck or back. The official patients sourcebook on brownsequard syndrome. This article cites 11 articles, 0 of which you can access for free at.
Cervical spinal extradural haematoma causing a transient. To raise the awareness of the appropriate management of unusual clinical presentation of cervical disc herniation. This condition is characterized by paralysis on one side of the body and loss of sensation in the other side of the body, which is usually caused by some sort of damage to the spinal cord. The spinothalamic tracts enter the cord and travel ipsilaterally for one to two levels before crossing over, and, therefore, the contralateral loss of. Postvaccinial influenza disseminated encephalopathy brown. Brown sequard syndrome bss is a wellknown entity that is most commonly caused by a penetrating injury to the spinal cord e. Cause lateral damage to one side of the cord may be caused by penetration injuries such as stab wounds but may also result from other etiologies and injury mechanisms such as road traffic.
A 71yearold, righthanded woman had right shoulder pain of sudden onset, with radiation into the forearm and hand, rapidly followed by weakness of her right arm and leg. Nov, 2012 brown sequard syndrome treatment treatment of bss is carried out by firstly understanding the pathology of the paralysis. We report a case of brown sequard syndrome bss caused by an accidental stab injury of the cervical spine that shows clear magnetic resonance imaging mri findings and clinical presentation. Brown sequard syndrome can be incomplete and temporary. The classic signs of a brown sequard syndrome are well documented in the literature. Surgical treatment of stenosis with myelopathy or incomplete spinal cord injury. This hemisection causes damage to the spinal cord tracts which are pathways for transfer of information to and from the brain. The points to note are total loss of sensation and flaccid paralysis at the level of the lesion due to destruction of nerve fibres at that segment of the spinal cord. Injury to half the spinal cord, or hemisection of the cord, can occur with trauma, tumor, or disc herniation.