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Am J Emerg Med 2019 Mar 27. Epub 2019 Mar 27.

Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan. Electronic address:

The frequency of stroke mimics among stroke patients has been reported to be up to 30%, and that in patients who receive thrombolytic therapy ranges between 1% and 16%. Atlantoaxial dislocation with myelopathy mimicking stroke is extremely rare. An 83-year-old man with a history of old cerebellar infarction presented to the emergency department with acute left hemiplegia after a chiropractic manipulation of the neck and back several hours before symptom onset. Read More

J Spinal Cord Med 2019 Mar 14:1-5. Epub 2019 Mar 14.

a Department of Neurology , SCTIMST , Trivandrum , India.

Context: Idiopathic spinal cord herniation (ISCH) remains an obscure, under recognised but potentially treatable entity among the etiologies of compressive myelopathy.

Findings: Here, we present a retrospective case series of eight patients of ISCH with their clinical features, imaging findings and long-term follow up data along with a relevant review of the literature. Mean age at presentation was 36 years with the duration of symptoms ranging from two months to more than thirty years. Read More

J Clin Immunol 2019 Feb 22;39(2):171-181. Epub 2019 Jan 22.

Centre de Référence National des Cytopénies Autoimmunes de l'Enfant (CEREVANCE), University Hospital of Bordeaux, Bordeaux, France.

Purpose: Immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AIHA) are associated in the definition of Evans syndrome (ES). The occurrence of neurological involvement in this population is poorly described and suggests an underlying primary immunodeficiency (PID). We aimed to describe the clinical manifestations, evolution, and PID profiles of these patients. Read More

Neurosurg Rev 2018 Dec 18. Epub 2018 Dec 18.

Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City, UT, USA.

Review of the literature with case illustration. Non-missile penetrating spinal injury (NPSI) represents a small subset of spinal cord injuries at tertiary trauma centers and is comprised mostly of knife violence. Strict guidelines for the management of penetrating spinal cord injury remain elusive given the variability of mechanisms, rarity of clinical experience, and paucity of prospective studies. Read More

Trauma Case Rep 2018 Dec 26;18:28-30. Epub 2018 Nov 26.

Gadjah Mada University, Sardjito Hospital, Yogyakarta, Indonesia.

Introduction: Combination between SCIWORA and Brown-Sequard syndrome in a patient is a rare condition. In SCIWORA, there is usually a delay in neurologic deficits which can potentially lead to misdiagnosis. Therefore, the clinician should have a good understanding of the course of the disease to make a good diagnosis and treatment. Read More

Oper Neurosurg (Hagerstown) 2018 Dec 4. Epub 2018 Dec 4.

Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio.

Background: Idiopathic ventral thoracic spinal cord herniation is a rare condition that usually presents with progressive myelopathy or Brown-Séquard syndrome. More than 100 cases have been reported with significant variance in surgical treatment strategies and likewise, significant variance in patient outcomes. Although laminectomy has often been used, to date, there is no consensus regarding the optimal surgical approach or strategy for ventral dural repair. Read More

Surg Neurol Int 2018 23;9:213. Epub 2018 Oct 23.

Department of Neurosurgery, Riverside University Health System, Riverside, California, USA.

Background: Brown-Sequard syndrome (BSS) is a well-known entity that is most commonly caused by a penetrating injury to the spinal cord (e.g., stab wound or gunshot wound). Read More

Medicine (Baltimore) 2018 Sep;97(37):e12377

The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province. P.R. China.

Rationale: Brown-Sequard syndrome (BSS) is manifested as ipsilateral motor deficit and contralateral sensory loss. BSS caused by herniated cervical disc is extremely rare and easily be misdiagnosed, and clinical features of this problem were not fully understood.

Patient Concerns: A 57-year-old man presented with a 3-month history of weakness in his right arm, and he experienced progressive right hemiparesis at 2 days before admission, along with contralateral deficit in sensation of pain and temperature below T2. Read More

Radiographics 2018 Jul-Aug;38(4):1201-1222

From the Department of Radiology, SUNY Downstate Medical Center, University Hospital of Brooklyn, 450 Clarkson Ave, Brooklyn, NY 11203 (V.K.K., V.V., Z.A.C., D.L.R.); Department of Radiology, University of California Davis Health System, Sacramento, Calif (M.B.); and Department of Radiology, University of Iowa Hospital and Clinics, Iowa City, Iowa (W.R.K.S.).

The ability to localize the three spinal tracts (corticospinal tract, spinothalamic tract, and dorsal [posterior] columns) involved in incomplete spinal cord syndromes at cross-sectional imaging and knowledge of the classic clinical manifestations of the various syndromes enable optimized imaging evaluation and provide clinicians with information that aids in diagnosis and treatment. The requisite knowledge for localizing these tracts is outlined. The authors review the spinal cord anatomy, blood supply, and course of these tracts and describe the various associated syndromes: specifically, dorsal cord, ventral cord, central cord, Brown-Séquard, conus medullaris, and cauda equina syndromes. Read More

Spinal Cord Ser Cases 2018 21;4:44. Epub 2018 May 21.

1Department of Physical Medicine, Rehabilitation and Sport Medicine, University of Puerto Rico-School of Medicine, San Juan, Puerto Rico.

Introduction: Brown-Séquard Syndrome (BSS) is one of the rarest incomplete spinal cord syndromes. The combination of injuries to peripheral nerves and the central nervous system result in an array of symptoms that can result in overlapping clinical presentations and delayed diagnosis. Early detection of spinal cord injury in patients with peripheral nerve injury has been observed to have a positive effect on outcomes. Read More

Korean J Neurotrauma 2018 Apr 30;14(1):20-23. Epub 2018 Apr 30.

Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea.

Objective: Acute hemiparesis is often an early presentation of acute ischemic stroke, though it can occur in various disorders. This study aimed to investigate the improper use of thrombolytic agents for patients with acute hemiparesis, following the misdiagnosis of acute ischemic stroke.

Methods: We analyzed the clinical and radiological data of nine patients initially misdiagnosed with cerebral stroke in the emergency room from May 2013 to January 2017. Read More

Trauma Surg Acute Care Open 2018 20;3(1):e000169. Epub 2018 Feb 20.

Department of Surgery, Memorial Hospital Colorado Springs, Aurora, Colorado, USA.

Case Rep Orthop 2018 4;2018:7620182. Epub 2018 Mar 4.

Laboratory of Diagnostic Pathology, Kochi Medical School, Kohasu Oko-cho, Nankoku, Kochi 783-8505, Japan.

This study reports on a 67-year-old woman with partial Brown-Séquard syndrome due to a recurrent cervical neurenteric cyst at C3 to C4. The myelopathic symptoms reappeared 22 years after a previous shunting operation performed posteriorly with a silicone tube connecting the intradural cervical cyst cavity to the subarachnoid space. We have now succeeded in removing the cyst nearly completely with the anterior approach. Read More

Neurology 2018 Mar;90(13):e1177-e1178

From the Division of Medicine (J.M.N.F.), Singapore Health Services; and Department of Neurology (G.J.N. and N.C.K.T.), National Neuroscience Institute, Singapore.

Asian J Neurosurg 2018 Jan-Mar;13(1):130-132

Delaware Orthopaedic Specialists, Wilmington, Delaware, USA.

Brown-Séquard syndrome, while uncommon, is a neurological condition that classically results from the hemisection of the spinal cord as a result of a penetrating injury to the spinal cord. We present a reported case of blunt trauma causing a high-energy cervical burst fracture/dislocation with a significant cord signal change producing Brown-Séquard syndrome. In this case, the burst fracture at the level of C5 obtained from the motor vehicle accident led to the damage of the left-sided lateral spinal thalamic tract, descending lateral cortical spinal tracts, and ascending dorsal column. Read More

J Clin Neurosci 2018 May 19;51:1-5. Epub 2018 Feb 19.

Department of Neurosurgery, American University of Beirut, Pierre Y. Abou Khater Building, John Kennedy Street, Beirut, Lebanon. Electronic address:

Idiopathic spinal cord herniation represents an uncommon and unique diagnostic entity, most commonly affecting middle-aged individuals, with a nearly twofold female predilection. It most characteristically affects the mid-thoracic spine, with the herniation occurring ventrally or ventrolaterally. Clinical presentation is typically a slowly-progressive myelopathy, with Brown-Séquard syndrome occurring more frequently than spastic paraparesis. Read More

World Neurosurg 2018 Apr 7;112:264-266. Epub 2018 Feb 7.

Department of Anesthesiology and Intensive Care, Military Hospital Sainte Anne, Toulon, France.

Background: While spontaneous spinal epidural hematomas are rare, 1 of the identified risk factors is vitamin K antagonist therapy.

Case Description: We present a case of a spontaneous spinal epidural hematoma occurring in a patient under treatment with dabigatran, a non-vitamin K oral anticoagulant. The initial hemiparesis symptom was misleading and was retrospectively identified as Brown-Séquard syndrome. Read More

J Stroke Cerebrovasc Dis 2018 Jun 13;27(6):e107-e109. Epub 2018 Feb 13.

Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Infarction of the spinal cord is a rare entity in clinical practice. Limited literature exists on spinal cord stroke treatment, and the management is often symptomatic. The anterior spinal cord syndrome is the most common phenomenology, but here we present 2 nontraumatic spinal hemicord infarctions in elderly patients and discuss the clinical and radiological characteristics. Read More

J Palliat Med 2018 Mar 29;21(3):399-402. Epub 2018 Jan 29.

1 Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center , Houston, Texas.

Neuropathic pain in cancer patients is often difficult to treat, requiring a combination of several different pharmacological therapies. We describe two patients with complex neuropathic pain syndromes in the form of phantom limb pain and Brown-Sequard syndrome who did not respond to conventional treatments but responded dramatically to the addition of levorphanol. Levorphanol is a synthetic strong opioid that is a potent N-methyl-d-aspartate receptor antagonist, mu, kappa, and delta opioid receptor agonist, and reuptake inhibitor of serotonin and norepinephrine. Read More

BMJ Case Rep 2018 Jan 26;2018. Epub 2018 Jan 26.

Orthopaedic Surgery, National University Hospital, Singapore, Singapore.

Spontaneous spinal epidural haematoma (SSEH) is a rare condition that requires urgent surgical intervention in order to prevent permanent neurological deficit. SSEH commonly presents as a paraparesis or tetraparesis. SSEH presenting as a hemiparesis is less common and in such situations, it can be mistaken for a cerebrovascular accident (CVA). Read More

Eur J Intern Med 2018 08 3;54:e3-e4. Epub 2018 Jan 3.

Department of Neurology, University of Kentucky, 740 South Limestone St., Kentucky Clinic - J464, Lexington, KY 40536-0284, United States. Electronic address:

World Neurosurg 2018 Mar 16;111:94-98. Epub 2017 Dec 16.

Department of Spine Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Background: Spinal osteochondroma is a rare but recognized cause of myelopathy. Brown-Séquard syndrome is a form of severe myelopathy characterized by a clinical picture of hemisection of the spinal cord. Brown-Séquard syndrome caused by osteochondroma is extremely rare, calling for individualized surgical procedures. Read More

J Clin Neurosci 2018 Mar 14;49:7-15. Epub 2017 Dec 14.

Department of Neurosurgery, Monash Health, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia. Electronic address:

Intramedullary spinal cord metastasis (ISCM) is rare and occurs most commonly in the setting of advanced malignancy. The optimal management pathways are not well defined and treatment outcomes from contemporary therapies remain variable. We report a case of a 49-year-old woman with known primary papillary thyroid carcinoma, who presented with rapidly progressive clinical features of Brown-Sequard syndrome. Read More

Acta Orthop Traumatol Turc 2018 May 23;52(3):240-243. Epub 2017 Nov 23.

Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Republic of Korea. Electronic address:

Brown-Sequard syndrome is an uncommon complication of atlantoaxial arthrodesis. A 50-year-old female visited our emergency department after falling from a ladder. Radiologic evaluations revealed chronic C1-2 instability with acute spinal cord injury. Read More

Medicine (Baltimore) 2017 Nov;96(45):e8647

aDepartment of Neurology bDepartment of MRI, Harrison International Peace Hospital, Hengshui, Hebei, China.

Rationale: Patients with Klippel-Feil syndrome (KFS) are always anomaly associated with vertebrobasilar dysplasia. That may present commonly as infarction of brainstem, medulla, and cerebellum. In this article, we reported a rare case of lateral medullary infarction (LMI) with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and KFS, and the 2 rare conditions that are causally related. Read More

World Neurosurg 2018 02 10;110:152-157. Epub 2017 Nov 10.

Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. Electronic address:

Background: Use of distal nerve transfer for improving upper limb function has been well described for patients with tetraplegic spinal cord injury and brachial plexus injuries but has not previously been described for Brown-Séquard type spinal cord injury. We describe our experience with 2 cases of combined Brown-Séquard injury and unilateral brachial amyotrophy.

Case Description: Patient 1, a 43-year-old woman, was involved in a motor vehicle accident and sustained left-side C5-7 level hemicord injury causing ipsilateral proximal arm weakness and sensory loss with contralateral hemisensory changes, neuropathic pain, and spasms. Read More

Neurocirugia (Astur) 2018 Jul - Aug;29(4):209-212. Epub 2017 Oct 20.

Department of Neurosurgery, San Carlos University Hospital, Madrid, Spain.

Cervical Traumatic SSH are very rare in literature. They are usually caused by cardiopulmonary diseases that increase vascular pressure causing spinal vessels rupture. In thoracolumbar spine, the spinal puncture is the most common cause. Read More

Brain 2017 05;140(5):1525-1532

University of California San Francisco - Department of Neurology, School of Medicine, San Francisco, California 94143-0114, USA.

World Neurosurg 2018 Jan 7;109:275-284. Epub 2017 Oct 7.

Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. Electronic address:

Objective: Spontaneous cervical intradural disc herniation (IDH) is a rare occurrence with limited and disparate information available regarding its presentation, diagnosis, and treatment. However, its accurate detection is vital for planning surgical treatment. In this review of the literature, we collected data from all cervical IDHs described to date. Read More

Ann Phys Rehabil Med 2018 Jan 6;61(1):27-32. Epub 2017 Oct 6.

Service de médecine physique et de réadaptation neurologique, centre hospitalier universitaire de Nantes, 85, rue Saint-Jacques, 44093 Nantes cedex 1, France. Electronic address:

Objectives: To specify outcomes and identify prognostic factors of neurologic and functional recovery in patients with an acute traumatic spinal cord injury (SCI) associated with cervical spinal canal stenosis (SCS), without spinal instability.

Methods: A retrospective study was conducted using data from a Regional Department for SCI rehabilitation in France. A description of the population characteristics, clinical data and neurological and functional outcomes of all patients treated for acute SCI due to cervical trauma associated with SCS was performed. Read More

Turk J Emerg Med 2017 Sep 3;17(3):115-120. Epub 2017 Jun 3.

Department of Emergency Medicine, Recep Tayyip Erdoğan University, Research and Training Hospital, Rize, Turkey.

Stroke is generally considered to be the first preliminary diagnosis in patients presenting with acute hemiparesia in the emergency department. But rarely in unexpected spontaneous neurological pathologies that may lead to hemiparesis. The data from 8 non-traumatic patients who underwent surgical treatment for brown-sequard syndrome (BSS) were reviewed retrospectively. Read More

Malays J Med Sci 2017 Aug 18;24(4):106-110. Epub 2017 Aug 18.

Department of General Medicine, RNT Medical College, Udaipur, Rajasthan, 313001 India.

A female patient aged 48 years presented with sub-acute onset of weakness in right upper and lower limb over the past one month and numbness over left side of body below neck level. Multiple sclerosis (MS) presenting as Brown-Séquard syndrome is very rare. We present a case of hemicord myelitis which presented as Brown-Séquard syndrome as a first manifestation, which was later diagnosed as MS during subsequent relapses. Read More

Surg J (N Y) 2016 Jul 17;2(3):e96-e101. Epub 2016 Sep 17.

Spine Surgery Unit, Talpiot Medical Leadership Program, Department of Neurosurgery, Sheba Medical Center, affiliated to Sackler Medical School, Tel-Aviv University, Tel-Aviv, Israel.

 Nontraumatic acute cervical disk herniation resulting in acute severe neurologic deficit is a rare entity described in a limited number of case reports. We describe the management and outcome in patients presenting with severe neurologic deterioration caused by acutely herniated cervical disks.  Four patients (mean age 39. Read More

Neurology 2017 05;88(21):e204

From the Departments of Medicine (Neurology) (G.B., W.S.J.) and Radiology & Diagnostic Imaging (T.K.), University of Alberta, Edmonton, Canada.

Radiol Case Rep 2017 Jun 22;12(2):257-260. Epub 2017 Mar 22.

Department of Radiology, Richmond University Medical Center, Staten Island, NY 11310.

Dabigatran etexilate is a relatively new anticoagulant from the class of direct thrombin inhibitors which is administered orally and does not require routine blood work monitoring. Dabigatran may be attractive to both clinicians and patients because of both its convenience and efficacy; however, clinical complications are still being elucidated. Here, we present a previously unreported case of spinal subarachnoid and subdural hematoma presenting as a Brown-Séquard-like myelopathy in a patient after minor trauma in the setting of Dabigatran anticoagulation. Read More

Eur Spine J 2017 05 25;26(Suppl 1):218-221. Epub 2017 Mar 25.

Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, Queen Square, London, WC1N 3BG, UK.

Purpose: Cervical spontaneous intradural disc herniation (IDH) is an extremely rare condition. We describe a unique case of a patient presenting with a Brown-Séquard syndrome (BSS) and Horner's syndrome (HS). This study aimed to report an unusual case of spontaneous cervical intradural disc herniation that presented with Horner's and Brown-Séquard syndrome (BSS) and discuss difficulties in preoperative diagnosis and treatment difficulties of intradural cervical disc. Read More

Interact Cardiovasc Thorac Surg 2017 06;24(6):976-977

Department of Cardiovascular Surgery, Nara Prefecture General Medical Center, Nara, Japan.

A 69-year-old man was admitted to our hospital with acute epigastric discomfort and subsequent paraplegia. Computed tomography revealed acute type B aortic dissection with a thrombosed false lumen. Magnetic resonance imaging did not reveal spinal cord infarction. Read More

Childs Nerv Syst 2017 Jun 28;33(6):993-997. Epub 2017 Feb 28.

Department of Clinical Radiology, Fukuoka Children's Hospital, Fukuoka, Japan.

Background: Lipomyelomeningocele (LMMC) is defined by a low-lying tethered spinal cord protruding posteriorly from the spinal canal and terminating in a lipomatous mass in the subcutaneous meningeal sac. The coexistence of LMMC with split cord malformation (SCM) is rare.

Clinical Presentation: We report on a patient with laterally protruded LMMC arising from the hemicord of SCM type I. Read More

Brain Nerve 2017 Feb;69(2):119-128

Department of Neurology, Brain Attack Center, Ota Memorial Hospital.

Clinical manifestations of spinal epidural hematoma are presented, and the cases mimicking acute ischemic stroke have been reviewed from the literature. Many reports described the cases of spinal epidural hematoma with acute hemiparesis mimicking ischemic stroke in which intravenous thrombolytic treatment with recombinant tissue plasminogen activator was considered. A correct diagnosis of acute ischemic stroke must be made within 4. Read More

Spinal Cord Ser Cases 2016 15;2:16037. Epub 2016 Dec 15.

Department of Spine Surgery, Changzheng Hospital, The Second Military Medical University , Shanghai, People's Republic of China.

Introduction: Brown-Sequard syndrome (BSS) has been reported in patients with various spinal pathologies, including spinal traumatic injuries, spinal cord neoplasms, epidural hematomas and spinal cord ischemia. Pure BSS caused by cervical disc herniation is very rare.

Case Presentation: We report a rare case of cervical disc herniation presenting as BSS associated with Horner syndrome (HS), which has not been reported up to now. Read More

Spine (Phila Pa 1976) 2017 Aug;42(16):E963-E968

*Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan †Department of Orthopedic Surgery, Konan Kosei Hospital, Aichi, Japan ‡Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan §Department of Orthopedic Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan ¶Department of Orthopedic Surgery, Meijo Hospital, Nagoya, Japan ||Department of Orthopedic Surgery, Aichi Medical University, Aichi, Japan **Department of Orthopedic Surgery, Toyohashi Municipal Hospital, Aichi, Japan ††Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan.

Study Design: A retrospective, multicenter, case-controlled study.

Objective: The aim of this study was to investigate the clinical and radiographical differences between thoracic idiopathic spinal cord herniation (ISCH) and spinal arachnoid cyst (SAC).

Summary Of Background Data: ISCH and SAC are relatively rare diseases. Read More

Pract Neurol 2017 Jan 21;17(1):6-12. Epub 2016 Nov 21.

Department of Clinical Neurosciences, UCL Institute of Neurology, Royal Free Campus, University College London, London, UK.

The diagnosis of spinal cord disease may be delayed or missed if the presentation does not conform to the expected pattern of a symmetrical spastic paraparesis with sphincter dysfunction and a sensory level. This may occur when a myelopathy has yet to evolve fully, or is highly asymmetrical, as in Brown-Séquard syndrome. Other potential distractions include fluctuating symptoms, as may accompany spinal cord demyelination, and pseudoneuropathic features, as seen acutely in spinal shock and in the chronic setting with some high cervical cord lesions. Read More

World Neurosurg 2017 Feb 17;98:881.e5-881.e8. Epub 2016 Nov 17.

Department of Neurosurgery, Landspítali University Hospital, Reykjavík, Iceland; Faculty of Medicine, University of Iceland, Reykjavík, Iceland.

Background: Primary spinal tumors are rare. Symptoms depend on the size and location of the tumor.

Case Description: A patient presented with a rare clinical finding, Brown-Séquard syndrome. Read More

Int J Health Sci (Qassim) 2016 Oct;10(4):592-595

Head of Neurosurgery Department, C.H.U. Hôpitaux Universitaires de Strasbourg, Strasbourg, FRANCE.

Idiopathic spinal cord herniation (ISCH) is a rare cause of progressive spinal myelopathy, which frequently presents as Brown-Sequard syndrome. A 50 year old woman consulted for difficulty in walking. On examination, the patient reported sensory deficit of temperature on the left side, associated with diminished anal sensitivity. Read More

J Neurosurg Spine 2017 Mar 4;26(3):384-387. Epub 2016 Nov 4.

Neurophysiology, Hospital Universitario de Burgos, Spain.

Idiopathic spinal cord herniation (ISCH) is a relatively rare and frequently misdiagnosed condition. It preferentially affects women and causes progressive thoracic myelopathy that presents as a Brown-Séquard syndrome or as spastic paraparesis. Although its etiology and pathogenesis are controversial, ISCH is characterized by the presence of an anterior dural defect that allows the incarceration of a segment of the cord. Read More

Neurology 2016 10;87(15):e178-e179

From the First Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Italy.

Int J Surg Case Rep 2016 29;28:135-138. Epub 2016 Sep 29.

Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, United States.

Introduction: Misdiagnosis of Brown-Séquard-like presentations can delay treatment; potentially endangering the positive outcomes a patient might otherwise have had. Stroke mimics can be perceived as signaling the end of urgent investigation and care once stroke is ruled out; however, stroke mimics themselves can require prompt care. Herein, we discuss an extremely rare case where stroke was ruled out, resulting in a lapse in care that lead to an exacerbated hemiparesis over the following week. Read More

PM R 2016 Sep 24;8(9S):S305. Epub 2016 Sep 24.

University of Puerto Rico, San Juan, Puerto Rico, United States.

World Neurosurg 2016 Dec 2;96:613.e1-613.e4. Epub 2016 Sep 2.

Department of Surgery, St. John Hospital and Medical Center, Detroit, Michigan, USA.

Background: Brown-Séquard syndrome is typically caused by penetrating trauma to the cervical spinal cord; however, other compressive and vascular occlusive etiologies have been previously described. It is extremely uncommon to have a delayed presentation as an extramedullary compressive lesion from the venous varix of an acquired spinal arteriovenous fistula.

Case Description: We present a case of a patient in the fifth decade of life, with a remote history of gunshot wound to the left thorax with progressive left-sided weakness and contralateral pain and temperature sensory loss secondary to cord compression from an acquired spinal arteriovenous fistula. Read More