This is the report of a 63yearold woman presenting with brownsequard syndrome due to spontaneous extradural c56 cervical disc herniation. Brownsequard syndrome is a rare presentation of cervical disc herniation but accurate diagnosis, and early anterior spinal cord decompression lead. Trigger 2 summary hemisection of the spinal cord brown sequard syndrome 2. Brown sequard syndrome free download as powerpoint presentation. Brownsequard syndrome is one of the incomplete types of spinal cord injuries. Place in the sage colleges library collection and reproduce for interlibrary loan. The diagram opposite shows the effects of hemitransection of the cord on the right side of the individual.
Brownsequard syndrome most commonly occurs in the the thoracic spine upper and middle back. Blunt trauma without associated fracture or ligamentous injury is a rare cause of brownsequard syndrome. Brownsequard syndrome accident lawyers chicago spinal. 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. Brown sequard syndrome is a rare disorder that affects males and females in equal numbers. Ipsilateral loss of proprioception due to posterior column involvement. Brownsequard syndrome is a characteristic spinal cord lesion that usually results from lateral hemisection of the cord. Charles edouard brownsequard, 18171894, mauritian physician. He could claim nationality in the united states because of his father, edward brown, an american sea caption. Hematoma is also a cause of brown sequard syndrome but is very rare and usually occurs with predisposing risk factors for bleeding anticoagulant therapy, hypertension.
Posttraumatic brownsequard syndrome has been well described in the literature. This hemitransection of the cord produces a characteristic set of clinical signs and symptoms. The patient was still conscious but could not walk unaided. Brownsequard syndrome of the cervical spinal cord after.
Brownsequard syndrome bss consists of asymmetric paresis with hypalgesia more marked on the less paretic side. 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. Rumination syndrome, or merycism, is a chronic motility disorder characterized by effortless regurgitation of most meals following consumption, due to the involuntary contraction of the muscles around the abdomen. Bss may be caused by a spinal cord tumor, trauma such as a puncture wound to the neck or back. Acute brownsequard syndrome neurology jama neurology. Brown sequard syndrome nord national organization for. There is no retching, nausea, heartburn, odour, or abdominal pain associated with the regurgitation citation needed, as there is with typical vomiting, and the regurgitated food is. Brown sequard syndrome is an incomplete pattern of injury showing a hemisection of the spinal cord. Ipsilateral flaccid paralysis at the level of the lesion.
Pdf on feb 1, 2018, eliza moskowitz and others published brownsequard syndrome find, read and cite all the research you need on. Pdf management of brownsequard syndrome in cervical disc. Famous victorian scientist, charlesedouard brownsequard, explained a rare spinal cord injury known as brownsequards syndrome bss. Diagnosis treatment xrays mri lumbar puncture biopsy immobilization surgery anticoagulation therapy proton pump inhibitors antibiotics pain medications high dose steroids long term carerehabilitation physical therapy occupational therapy orthotic devices ligaments, muscles and.
Brownsequard syndrome as a first presentation of multiple sclerosis. Learn vocabulary, terms, and more with flashcards, games, and other study tools. This quiz will help you find out how much you know about spinal cord injury. Y, 40 years old, was in a traffic accident and was taken to the emergency unit. This syndrome provides a very clear demonstration of differential sensory and motor loss, which can be easily derived from the spinal tract anatomy. The cord basically controls and handles the whole body together. Famous victorian scientist, charlesedouard brown sequard, explained a rare spinal cord injury known as brown sequards syndrome bss in 1849. Extramedullary spinal neoplasm, cervical disc herniation, spinal epidural hematoma, multiple sclerosis and myelitis are reported as uncommon causes.
Davis, charlotte bsn, rn, ccrn nursing made incredibly easy. The annual incidence of all forms of spinal cord injury is estimated to be 3040 per 1,000,000 people. His father was lost with his ship soon after the marriage. Brownsequard lesion loss of ipsilateral proprioception, light touch and motor function loss of contralateral pain and temperature sensation due to hemisection of the cord due to penetrating injury incomplete lesions most common.
The classical syndrome, which is the consequence of hemisection of the spinal cord, consists of ipsilateral weakness and loss of proprioceptive and vibratory sensation on the same side, due to disruption of the corticospinal tracts and dorsal columns, respectively. Brownsequard syndrome is caused by damage to one half of the spinal cord, i. An emergency head computed tomographic scan showed no. Disruption of descending lateral corticospinal tracts, ascending dorsal column and ascending spinothalamic tracts leads to ipsilateral hemiplegia and loss of proprioception and vibration with contralateral loss of pain and temperature sensation below the level of injury 1. Brownsequard syndrome is caused by damage to one half of the spinal cord either left or right. There are several causes of brown sequard syndrome, including. 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. Brown sequard syndrome most commonly occurs in the the thoracic spine upper and middle back. Diagnostics of incomplete brownsequard syndrome caused by. The incidence of brown sequard syndrome has been estimated to be 2% of all traumatic spinal cord injuries. It occurs when there is damage more to one side of the cord than the other, often from gun shot wounds or stab wounds, but can occur from other mechanisms as well. Brown sequard syndrome nervous system neuroanatomy.
There are several causes of brownsequard syndrome, including. Followup imaging showed decreased cord swelling with persistent increased signal. Brown sequard syndrome as a result of cervical epidural hematoma is a rare entity with only a handful of cases reported in literature. Ipsilateral loss of all sensory modalities at the level of the lesion. She had no speech difficulty, facial weakness, or neck pain. Spine and spinal cord injuries san francisco general. 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. Hemisection of spinal cord the clinical manifestations of syndrome. The current volume adds additional historical background and illustrations, resulting in material more accessible to readers outside of medicine and physiology. 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. Brownsequard syndrome after blunt cervical spine trauma. Brown sequard syndrome secondary to a spontaneous cervical. 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. Eduard brown sequard in 1850 as ipsilateral upper motor neuron motor weakness below.
Contralateral loss of pain and temperature due to involvement of lateral spinothalamic tract. Know the causes, symptoms, treatment, prognosis, pathophysiology and diagnosis of brownsequard syndrome. The chicago spinal cord injury attorneys 888 4245757 at rosenfeld injury lawyers represent victims of the horrific condition caused by trauma from a car crash, slip and fall incident, medical malpractice, and onthejob accidents. 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. Other synonyms are crossed hemiplegia, hemiparaplegic syndrome, hemiplegia et hemiparaplegia spinalis and spinal hemiparaplegia historical perspective. Rehabilitation of a patient with symptoms of brown. Brownsequard syndrome is a serious, but rare, condition that paralyzes the victim on one side of the body brought on by an injury to the back or neck.