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Front Pain Res (Lausanne) 2022 9;3:910954. Epub 2022 Jun 9.

Department of Anatomy, University of California San Francisco, San Francisco, CA, United States.

Traditional medical neuroanatomy/neurobiology textbooks teach that pain is generated by several ascending pathways that course in the anterolateral quadrant of the spinal cord, including the spinothalamic, spinoreticular and spinoparabrachial tracts. The textbooks also teach, building upon the mid-19th century report of Brown-Séquard, that unilateral cordotomy, namely section of the anterolateral quadrant, leads to contralateral loss of pain (and temperature). In many respects, however, this simple relationship has not held up. Read More

J Neurotrauma 2022 Jun 16. Epub 2022 Jun 16.

Rutgers New Jersey Medical School, 12286, Physical Medicine & Rehabilitation, Newark, New Jersey, United States.

The demographics of acute traumatic spinal cord injury (SCI) have changed over the last few decades, with a significant increase in age at the time of injury, a higher percentage of injuries caused by falls, and incomplete tetraplegia becoming the most common type of neurological impairment. Incomplete SCI syndromes, most specifically central cord syndrome (CCS), anterior cord syndrome (ACS) and Brown Sequard syndrome (BSS), constitute a substantial proportion of incomplete tetraplegia and SCI overall. Nevertheless, the updated incidence of these syndromes is not well known and their estimates vary considerably, largely due to methodological inconsistencies across prior studies. Read More

Clin Pract Cases Emerg Med 2022 May;6(2):162-165

Creighton University Arizona Health Education Alliance, Valleywise Health, Department of Emergency Medicine, Phoenix, Arizona.

Introduction: Brown-Séquard syndrome is a rare neurological disorder due to hemisection of the spinal cord that can occur from a variety of causes, most commonly trauma.

Case Report: We present a case of a 25-year-old woman presenting with Brown-Séquard syndrome as her first clinical presentation of multiple sclerosis.

Conclusion: This case highlights the need to have demyelinating disease on the differential as an exceedingly rare, but important, possible cause of Brown-Séquard syndrome. Read More

Vasc Specialist Int 2022 Jun 30;38:12. Epub 2022 Jun 30.

Departments of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.

We present a case of Brown-Séquard syndrome (BSS) after thoracic endovascular aortic repair (TEVAR) to treat Stanford type B aortic dissection. A 49-year-old male presented to the emergency department with acute tearing pain between the scapulae, connected to respiratory movements. Computed tomography showed Stanford type B aortic dissection from the left subclavian artery to the level of the 11th thoracic vertebra. Read More

Dis Mon 2022 May 26:101420. Epub 2022 May 26.

Emergency Medicine Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Clin Neurophysiol Pract 2022 22;7:129-134. Epub 2022 Apr 22.

Department of Neurosurgery, University of Szeged, Hungary.

Introduction: Intramedullary hematoma is an uncommon, serious neurological disease, representing a diagnostic challenge. The preferred treatment is surgical. In most of the cases the lesion can be identified macroscopically. Read More

Undersea Hyperb Med 2022 Second Quarter;49(2):563-568

Duke University, Department of Anesthesiology, Division of Hyperbaric Medicine and Environmental Physiology, Durham, North Carolina U.S.

Introduction: This case report describes an initially overlooked Type II decompression sickness (DCS) occurrence that was confused with a cerebral vascular accident in a patient with chronic atrial fibrillation (AF). The purpose of this case report is to reinforce the maxim that DCS needs to be suspected anytime a scuba diver experiences signs or symptoms compatible with DCS after completing a scuba dive.

Methods: A 71-year-old scuba diver with a history of AF and who was taking warfarin made four dives, all with maximum depths less than 60 fsw (20 msw) over a 10-hour interval. Read More

JCI Insight 2022 Jun 22;7(12). Epub 2022 Jun 22.

Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Understanding the reorganization of neural circuits spared after spinal cord injury in the motor cortex and spinal cord would provide insights for developing therapeutics. Using optogenetic mapping, we demonstrated a transhemispheric recruitment of neural circuits in the contralateral cortical M1/M2 area to improve the impaired forelimb function after a cervical 5 right-sided hemisection in mice, a model mimicking the human Brown-Séquard syndrome. This cortical reorganization can be elicited by a selective cortical optogenetic neuromodulation paradigm. Read More

Surg Neurol Int 2022 15;13:150. Epub 2022 Apr 15.

Division of Neurosurgery, Valleywise Health Medical Center, Phoenix, Arizona, United States.

Background: The association of Brown-Sequard syndrome (BSS) and hangman fracture (HF) is rarely reported.

Case Description: We present a case of a 28-year-old female with a HF sustained after a motor vehicle accident and BSS. Diagnosis was established based on typical loass of motor function ipsilaterally and loss of pain and temperature sensation contralaterally. Read More

Int J Surg Case Rep 2022 Apr 17;93:106951. Epub 2022 Mar 17.

Faculty of medicine of Tunis, University Tunis-El Manar, Department of Neurosurgery, Trauma and Burns Center, Ben Arous, Tunisia.

Introduction: Herniation of the thoracic spinal cord is a rare pathology related to the genesis of a breach in the anterior dura. Adding to the previously published cases, we report our department's experience with 2 cases of young adults who presented with transdural spinal cord herniation following spinal trauma.

Presentation Of The Cases: We report the cases of 2 men aged 27 and 57, with history of spinal trauma, who presented diverse clinical complaints (motor impairment, genito-sphincteric disorders, etc. Read More

Spinal Cord Ser Cases 2022 03 15;8(1):32. Epub 2022 Mar 15.

Department of Physical Medicine and Rehabilitation, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.

Introduction: Spinal cord injury after manual manipulation of the cervical spine is rare and has never been described resulting from a patient performing a manual manipulation on their own cervical spine. To the best of our knowledge, this is the first well-documented case of this association.

Case Presentation: A healthy 29-year-old man developed Brown-Sequard syndrome immediately after performing a manipulation on his own cervical spine. Read More

Pediatr Neurol 2022 04 21;129:46-47. Epub 2022 Jan 21.

Department of Neurology and Ophthalmology, Michigan State University, East Lansing, Michigan.

Clin Exp Emerg Med 2021 Dec 31;8(4):336-339. Epub 2021 Dec 31.

Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

Epidural hematoma with Brown-Sequard syndrome caused by an epidural injection is a rarely found condition in the emergency department (ED). We report an unusual case of Brown-Sequard syndrome in a 55-year-old man who presented at the ED with right-sided weakness and contralateral loss of pain and temperature sensation after a cervical epidural injection for shoulder pain. Cervicla spine magnetic resonance imaging showed an epidural hematoma from C4 to C6. Read More

BMC Infect Dis 2022 Jan 4;22(1). Epub 2022 Jan 4.

Department of Neurosurgery, Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Gyeonggi-do, 15355, Republic of Korea.

Background: Intramedullary parasitic infection is extremely uncommon, and clinical presentation of Brown-Sequard syndrome is even rarer.

Case Presentation: The authors report a case involving a 57-year-old woman with Brown-Sequard syndrome, in whom magnetic resonance imaging and clinical and epidemiological features were similar to those of acute transverse myelitis. Myelotomy suggested inflammation caused by latent parasite eggs in the spinal cord. Read More

Surg Neurol Int 2021 6;12:501. Epub 2021 Oct 6.

Department of Neurosurgery, Maastricht University Medical Center +, Maastricht, Netherlands.

Background: Several case reports about spinal cord compression due to hyperostosis at the craniocervical junction are available. However, compression at C1-C2 solely due to ossification of the posterior longitudinal ligament (OPLL) is rare.

Case Description: A 50-year-old Asian male, with a history of lumbar spinal canal stenosis, presented with a progressive quadriparesis within 3 months. Read More

Am J Case Rep 2021 Jul 18;22:e930036. Epub 2021 Jul 18.

Department of Radiology, King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia.

BACKGROUND Traumatic spinal cord injuries are quite common; however, a rare form of incomplete spinal cord injury is Brown-Sequard syndrome. Brown-Sequard syndrome is defined by the National Institute of Neurological Disorders and Strokes as "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." CASE REPORT A 33-year-old man was brought to the Emergency Department by Saudi Red Crescent with multiple stab wounds on the left upper thoracic and lower cervical regions. Read More

Case Rep Infect Dis 2021 2;2021:5533686. Epub 2021 Jun 2.

Clinical Infection Unit, St. George's Hospital, BlackshawRoad, Tooting, London SW17 0QT, UK.

Syphilis is an ancient condition which still is of global concern today. Despite better awareness amongst clinicians and improving diagnostics, it remains likely underdiagnosed in part because of its namesake the 'great imitator.' While many patients suffer primary or secondary disease, tertiary syphilis characterised by gumma is rare, especially in the context of neurosyphilis. Read More

J Surg Case Rep 2021 May 18;2021(5):rjab163. Epub 2021 May 18.

Instituto Guatemalteco de Seguridad Social, Ortopedia y Traumatología, Guatemala City, Guatemala.

The annual incidence of traumatic spinal cord injury worldwide is 35 patients per million; this incidence is likely to be much higher in Latin America, where stab injuries are a common incidence. Stab injuries to the spine represent a small percentage of these cases; these are rare injuries; its management may differ compared with other penetrating injuries; these injuries are frequently complicated with neurological damage; the most common clinical manifestation is Brown-Sequard syndrome, and the most common segment involved is the thoracic region; stab injuries to the lumbar spine are rarely found in the literature. The management of patients without neurological involvement is controversial due to the risk of neurologic deterioration intraoperatively. Read More

J Clin Neurosci 2021 Jun 31;88:47-51. Epub 2021 Mar 31.

National Neuroscience Institute, Department of Neurology, Singapore.

Objective: This study aims to describe the clinical characteristics of patients with sulcal artery syndrome, and between those with vertebral artery dissection against those without.

Methods: We report three cases of sulcal artery syndrome without vertebral artery dissection, performed a systematic review and retrospective analysis of the characteristics of patients with sulcal artery syndrome in available literature, and compared the clinical features of those with vertebral artery dissection against those without.

Results: We report 3 patients with sulcal artery syndrome, and analysed them with 17 other cases identified in literature between January 1990 till April 2020. Read More

J Med Case Rep 2021 May 12;15(1):233. Epub 2021 May 12.

Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

Background: Brown-Séquard syndrome often occurs in spinal cord injury, and few myelitis patients present with Brown-Séquard syndrome.

Case Presentation: A 33-year-old Han man was admitted with neck pain plus numbness in the right limbs for 2 days and weakness in the left limbs for 1 day. Examination was significant for left limbs with grade 4 muscle power, positive left Babinski sign, diminished vibration sensation in the left limbs and decreased pain below the right clavicle dermatome. Read More

Medicine (Baltimore) 2021 Apr;100(16):e25588

Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Rationale: A case of traumatic atlanto-axial rotatory subluxation (AARS), dens fracture, rupture of transverse atlantal ligament (TAL), and subaxial spinal cord injury without radiographic abnormality (SCIWORA) of Brown-Sequard syndrome has never been reported in a child.

Patient Concerns: A 7-year-old boy presented to hospital with torticollis, neck pain, and limited neck rotation after a seat-belt injury sustained during a car accident. Neurologic examination revealed right-side motor weakness and left-side sensory abnormality, known as Brown-Sequard syndrome. Read More

Pain Med 2022 01;23(1):213-217

Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Nursing 2021 Apr;51(4):62-66

Ellie Z. Franges is an NP in neurosurgery at Lehigh Valley Health Network in Allentown, Pa.

Abstract: Incomplete spinal cord injury is challenging to diagnose and treat. This overview of Brown-Séquard syndrome outlines key assessment and nursing considerations important to enhancing recovery outcomes. Read More

Ann Med Surg (Lond) 2021 Mar 5;63:102149. Epub 2021 Feb 5.

General Practitioner, Tangerang District General Hospital, Tangerang, Indonesia.

Introduction: This case report presents a rare case of vertebral artery and spinal cord injury due to air rifle pellet.

Case Presentation: A previously healthy 19-year-old male was shot on his left neck incidentally during recreational air rifle game. He was taken to the other hospital before being referred to our hospital. Read More

Oper Neurosurg (Hagerstown) 2021 06;21(1):E48

Department of Spine surgery, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.

Thoracic disc herniation is a rare and severe condition, whose treatment may have complications including dural tears. Although benign in most cases, dural tears may induce iatrogenic transdural herniation of the spinal cord. The video demonstrates the diagnosis and surgical treatment of iatrogenic transdural herniation of the spinal cord. Read More

Radiologe 2021 Mar 15;61(3):242-250. Epub 2021 Feb 15.

Klinik für Neurologie, Knappschaftskliniken Saar, Standort Sulzbach, An der Klinik 10, 66280, Sulzbach, Deutschland.

Background: Spinal cord injuries are frequently associated with severe clinical-neurological deficits. These are evident with specific symptoms and syndromes. Hereby, a thorough knowledge of spinal neuroanatomy is essential. Read More

Global Spine J 2021 Feb 11:2192568221991802. Epub 2021 Feb 11.

Department of Orthopaedics & Rehabilitation, University of Rochester School of Medicine and Dentistry, Rochester, New York, NY, USA.

Study Design: Retrospective.

Objective: To evaluate functional outcomes and characteristics associated with gunshot wound (GSW) to the spine.

Methods: Patients with GSW to the spine managed at a Level 1 Trauma Center from January 2003 to December 2017 were enrolled. Read More

J Surg Case Rep 2020 Dec 26;2020(12):rjaa460. Epub 2020 Dec 26.

Neurosurgery Department, Department of Neurosurgery, King's College Hospital Foundation Trust, London, UK.

Brown-Séquard syndrome (BSS) is a rare neurological condition caused by a hemi-lesion of the spinal cord and was first described in the 1800s. BSS is characterized by an ipsilateral absence of motor control and discriminatory/proprioceptive/vibratory sensation at and below the spinal level involved, associated with loss of contralateral temperature and pain sensation a couple of vertebral segments below the lesion. BSS is commonly associated with trauma, but can also be iatrogenic. Read More

Diving Hyperb Med 2020 Dec;50(4):325-331

Neurology Department, Fiona Stanley Hospital, Murdoch, Australia.

Introduction: Spinal cord infarction (SCI) is a potentially devastating disorder presenting with an acute anterior spinal artery syndrome, accounting for an estimated 1% of stroke presentations. Aetiologies include aortic surgical complications, systemic hypotension, fibrocartilaginous embolism and vascular malformations. Diagnosis is clinical combined with restriction on diffusion-weighted magnetic resonance imaging (MRI). Read More

BMJ Case Rep 2020 Nov 30;13(11). Epub 2020 Nov 30.

General Surgery, Albert Einstein College of Medicine, Bronx, New York, USA

Brown-Séquard syndrome (BSS) presents as an ipsilateral loss of motor function, proprioception and vibratory sensation accompanied by contralateral pain and temperature loss two to three levels below the level of the injury. It is one of the syndromes associated with incomplete transection of the spinal cord. Classic BSS is rare as most patients present with mixed neurological deficits related to damage of the spinal cord and surrounding structures. Read More