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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 2021 Apr 7. Epub 2021 Apr 7.

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

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 Jun;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

Clin Lung Cancer 2020 Oct 31. Epub 2020 Oct 31.

Department of Pneumology, KU Leuven University Hospitals Leuven, Leuven, Belgium.

World Neurosurg 2021 01 10;145:376-380. Epub 2020 Oct 10.

Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan.

Background: Among chondrosarcomas arising from bones and soft tissues, mesenchymal chondrosarcoma (MCS), especially primary spinal intradural extramedullary MCS, is extremely rare, and only 18 cases have been reported to date. We report an adult case of this rare condition mimicking meningioma.

Case Description: A 42-year-old woman presented with paraplegia and sensory disturbance associated with right-sided Brown-Séquard syndrome following back pain. Read More

A A Pract 2020 Jul;14(9):e01271

From the Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.

While epidural analgesia is generally considered safe in parturients with common spinal cord injuries, little is known about the safety or efficacy of this technique in patients with Brown-Séquard syndrome, a rare disorder consisting of 2% of traumatic spinal cord injuries. We present a case of successfully placing and managing a labor epidural in a patient with Brown-Séquard syndrome who developed a dense block with minimal local anesthetic requirements. To minimize trauma and preserve potentially vulnerable remodeled neural pathways, we recommend cautious, slow epidural medication dosing and use of neuraxial ultrasound rather than landmark-based techniques in these patients. Read More

Am J Case Rep 2020 Aug 3;21:e922416. Epub 2020 Aug 3.

Emergency Department, Hamad Medical Corporation, Doha, Qatar.

BACKGROUND Spontaneous spinal subdural hematoma is a rare condition that can lead to devastating neurologic deficits, usually caused by coagulation abnormalities, trauma, underlying neoplasm, or arteriovenous malformation. The patient presents with local and/or radicular pain, followed by loss of sensory, motor, bladder, and bowel function. CASE REPORT A 25-year-old patient presented with left-sided weakness preceded by nontraumatic upper back pain. Read More

Ann Hematol 2020 Nov 17;99(11):2711-2713. Epub 2020 Jul 17.

Medical Intensive Care and Infectious Diseases Unit, Saint Andre Hospital - CHU BORDEAUX, Bordeaux, France.

Clin Neurol Neurosurg 2020 08 29;195:106055. Epub 2020 Jun 29.

Department of Neurosurgery, Prasat Neurological Institute, Bangkok, Thailand.

Radiol Case Rep 2020 Aug 27;15(8):1366-1368. Epub 2020 Jun 27.

University of California Irvine School of Medicine, 101 The City Drive South, Building 20, Room 144, Orange, CA 92868, USA.

Brown-Sequard Syndrome is a neurologic disorder caused by partial spinal cord injury and disruption of the corticospinal tract, dorsal columns, and spinothalamic tract. We present a 32-year-old male with partial T11-12 cord transection due to a penetrating knife injury. In addition to the classical neurological symptoms of Brown-Sequard Syndrome, he also exhibited ipsilateral peripheral vasodilatation below the level of injury. Read More

Spinal Cord Ser Cases 2020 07 6;6(1):57. Epub 2020 Jul 6.

Vascular Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Introduction: Intramural haematoma (IMH) describes the presence of blood within the aortic wall, and is associated with a significant morbidity and mortality. Early diagnosis is essential for institution of medical, and sometimes surgical, management. Neurological complications have rarely been described during the initial presentation of IMH, or other forms of acute aortic syndrome. Read More

World Neurosurg 2020 10 27;142:152-154. Epub 2020 Jun 27.

Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

Idiopathic spinal cord herniation is a rare cause of progressive myelopathy that can result in severe disability. In the following report, an illustrative case and associated video in the surgical management of ventral thoracic spinal cord herniation is presented and discussed. Spinal cord herniation is most commonly observed in the thoracic spine and is characterized by ventral displacement of the spinal cord through a defect in the dura. Read More

Rev Neurol 2020 Jul;71(1):26-30

Hospital Universitario Donostia, San Sebastián, España.

Introduction: Idiopathic medullary herniation is an infrequent disease, which shows up in clinical form as a progressive mielopathy, most commonly known as the Brown-Sequard syndrome. Its anatomical base is a dural defect where a portion of anterior spinal cord gets progressively incarcerated. The MRI and myelo-CT scan show a bending of the spinal cord in the form of a «bell tent» towards the anterior dural sheath at the mid-dorsal portion mainly. Read More

J Clin Neurosci 2020 Jul 11;77:222-224. Epub 2020 May 11.

Department of Neurology, Rouen University Hospital and University of Rouen, 76031 Rouen Cedex, France. Electronic address:

Fibrocartilaginous embolism (FCE) is a rare and probably under diagnosed cause of spinal cord infarction presumably due to acute embolization of nucleus pulposus fragments into the spinal circulation. Concomitant cerebral involvement is much rarer and often asymptomatic. Although the definitive diagnosis is histologic, certain criteria have been proposed to support the diagnosis in living patients, such as absence of vascular risk factors, acute onset or antecedent of valsalva maneuver before the episode and the exclusion of potential differential diagnoses. Read More

Wien Klin Wochenschr 2020 09 5;132(17-18):545-546. Epub 2020 May 5.

Department of Neurology, Municipal Hospital Landshut, Robert-Koch Str. 1, 84034, Landshut, Germany.

Rinsho Shinkeigaku 2020 May 18;60(5):351-357. Epub 2020 Apr 18.

Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University.

The patient was a 40-year-old woman who was previously diagnosed with systemic lupus erythematosus and myasthenia gravis and had received prednisolone and tacrolimus for more than 7 years. In February 2017, she noticed pain in her lower back and weakness of the lower limbs, and was referred to our hospital on day 5. She had shingles in the right lower thoracic dermatomes and Brown-Séquard syndrome with right-sided dominant weakness in her lower limbs and left-sided superficial sensory disturbance below the L1 level. Read More

J Vis Exp 2020 03 24(157). Epub 2020 Mar 24.

Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Department of Neurological Surgery and Goodman Campbell Brain and Spine, Indiana University School of Medicine;

Incomplete spinal cord injury (SCI) often leads to impairments of sensorimotor functions and is clinically the most frequent type of SCI. Human Brown-Séquard syndrome is a common type of incomplete SCI caused by a lesion to one half of the spinal cord which results in paralysis and loss of proprioception on the same (or ipsilesional) side as the injury, and loss of pain and temperature sensation on the opposite (or contralesional) side. Adequate methodologies for producing a spinal cord lateral hemisection (HX) and assessing neurological impairments are essential to establish a reliable animal model of Brown-Séquard syndrome. Read More

J Coll Physicians Surg Pak 2020 Mar;30(3):321-323

Department of Rheumatology, Shaikh Zayed Postgraduate Medical Institute, Lahore, Pakistan.

Aquaporin-4 antibodies are hallmark of neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorders (NMOSD) that are distinct disease entities. We report a 24-year male with NMO, who presented with Brown-Sequard syndrome. Clinical and laboratory parameters confirmed the diagnosis of systemic lupus erythematosus (SLE). Read More

BMC Neurol 2019 Dec 12;19(1):321. Epub 2019 Dec 12.

Department of Radiology, the First Hospital of JiLin University, Xinmin St. #71, Changchun, 130021, China.

Background: Spinal cord infarction (SCI) is rarely caused by vertebral artery dissection (VAD), which is an important cause of posterior circulation stroke in young and middle-aged patients. We report the case of a middle-aged patient without obvious risk factors for atherosclerosis who had SCI from right VAD.

Case Presentation: An otherwise healthy 40-year-old man presented with acute right-sided body weakness. Read More

Surg Neurol Int 2019 25;10:210. Epub 2019 Oct 25.

Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran.

Background: Spontaneous spinal epidural hematomas (SEHs) due to the utilization of factor Xa inhibitors are rare.

Case Description: A 66-year-old female presented with a Brown-Sequard syndrome attributed to a cervical epidural hematoma secondary to the utilization of rivaroxaban, one of the factor Xa inhibitors. Following a cervical laminectomy for the evacuation of the hematoma, the patient completely recovered. Read More