Clinical CommunicationsBrown–sequard syndrome due to isolated blunt trauma1
Introduction
First described in 1849 by Charles Edouard Brown–Sequard 1, 2, the syndrome that bears his name refers to a characteristic spinal lesion that usually results from partial hemisection of the spinal cord. Typically occurring in males aged 15–50, the anatomic lesion results in ipsilateral motor and proprioception loss and contralateral loss of pain and temperature sensation. The etiology of this lesion varies from tumor to direct spinal cord trauma. Classically, the syndrome is associated with penetrating injury to the back or blunt injuries involving fractured vertebrae. We present a case of Brown–Sequard syndrome, following multiple blows from a lead pipe, which did not include any spinal column fractures or instability.
Section snippets
Case report
An 18-year-old male presented to our facility, a Level I trauma center, after transfer from a small community emergency department (ED) with a diagnosis of possible spinal cord injury. The patient had received multiple blows with a lead pipe over the neck and back. He had then fallen, striking the right side of his head. Immediately after the assault, he stated that he was unable to move because he felt “numb.” The patient was evaluated at the community ED where plain radiographs of the
Discussion
Brown–Sequard syndrome is a unique set of neurologic findings associated with hemisection of the spinal cord. Classically, there is a contralateral loss of pain and temperature sensation, and an ipsilateral loss of position and vibration sensation, as well as ipsilateral paralysis and hyperaesthesias (3). Light touch usually is not affected. Distribution of Brown–Sequard syndrome is 75% thoracic, 17% cervical, and 8% lumbar (2).
The motor paralysis seen in this syndrome stems from disruption of
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2019, Clinical and Experimental Emergency MedicineBrown sequard syndrome caused by paper scissors penetration
2014, Journal of Neurological SciencesBrown-Séquard syndrome in a 11-year-old girl due to penetrating glass injury to the thoracic spine
2013, European Journal of Orthopaedic Surgery and TraumatologyPneumocephalus and Brown-Sequard syndrome caused by a stab wound to the back
2011, EMA - Emergency Medicine Australasia
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Clinical Communications (Adults) is coordinated by Ron M. Walls, md, of Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts