Korean J Neurotrauma.  2015 Oct;11(2):180-182. 10.13004/kjnt.2015.11.2.180.

Brown-Sequard Syndrome after an Accidental Stab Injury of Cervical Spine: A Case Report

Affiliations
  • 1Department of Neurosurgery, Yeungnam University College of Medicine, Daegu, Korea. sw902@ynu.ac.kr

Abstract

We report a case of Brown-Sequard syndrome (BSS) caused by an accidental stab injury of the cervical spine that shows clear magnetic resonance imaging (MRI) findings and clinical presentation. A 42-year-old woman was brought into the emergency department after a stab injury on the right side of the posterior neck from a knife that was lying in a fruit basket after slipping. The patient complained of hemiparesis of the right-side extremities, and ipsilateral hypoesthesia and contralateral sensory loss of pain and temperature were also found on neurological examination. MRI showed a signal change of the C6-7 cord level and the tract of the stab wound through the posterior neck. Irrigation and primary closure of the laceration was performed under the impression of BSS. The neurologic deficit was improved with rehabilitation therapy.

Keyword

Brown-Sequard syndrome; Cervical vertebrae; Spinal cord injuries

MeSH Terms

Adult
Brown-Sequard Syndrome*
Cervical Vertebrae
Deception
Emergency Service, Hospital
Extremities
Female
Fruit
Humans
Hypesthesia
Lacerations
Magnetic Resonance Imaging
Neck
Neurologic Examination
Neurologic Manifestations
Paresis
Rehabilitation
Spinal Cord Injuries
Spine*
Wounds, Stab

Figure

  • FIGURE 1 A lacerated wound in the right posterior cervical region, measuring 3 cm in length is shown.

  • FIGURE 2 A: Magnetic resonance imaging (MRI) reveals an injured tract, through the posterior neck (arrow). B: MRI reveals disruption of the C6-7 interlaminar structures and ligamentum flavum (arrow). C: There is high signal intensity lesion at cervical spinal cord in T2-weighted MRI (arrows). D: Axial T2-weighted MRI also shows injured tract and signal change in the spinal cord.


Reference

1. Diabira S, Henaux PL, Riffaud L, Hamlat A, Brassier G, Morandi X. Brown-Sequard syndrome revealing intradural thoracic disc herniation. Eur Spine J. 2011; 20:65–70. PMID: 20589517.
Article
2. Herr RD, Barrett J. An unusual presentation of Brown-Sequard syndrome. Ann Emerg Med. 1987; 16:1285–1288. PMID: 3662191.
Article
3. Kamaoui I, Maaroufi M, Benzagmout M, Sqalli Houssaini N, Boujraf S, Tizniti S. MRI findings in spinal cord penetrating injury: three case reports. J Neuroradiol. 2007; 34:276–279. PMID: 17628679.
4. Kobayashi N, Asamoto S, Doi H, Sugiyama H. Brown-Sèquard syndrome produced by cervical disc herniation: report of two cases and review of the literature. Spine J. 2003; 3:530–533. PMID: 14609700.
Article
5. Kohno M, Takahashi H, Yamakawa K, Ide K, Segawa H. Postoperative prognosis of Brown-Séquard-type myelopathy in patients with cervical lesions. Surg Neurol. 1999; 51:241–246. PMID: 10086485.
Article
6. Lee HM, Kim NH, Park CI. Spinal cord injury caused by a stab wound--a case report. Yonsei Med J. 1990; 31:280–284. PMID: 2281688.
7. Lipschitz R, Block J. Stab wounds of the spinal cord. Lancet. 1962; 2:169–172. PMID: 14465744.
Article
8. Mastronardi L, Ruggeri A. Cervical disc herniation producing Brown-Sequard syndrome: case report. Spine (Phila Pa 1976). 2004; 29:E28–E31. PMID: 14722422.
9. McCarron MO, Flynn PA, Pang KA, Hawkins SA. Traumatic Brown-Séquard-plus syndrome. Arch Neurol. 2001; 58:1470–1472. PMID: 11559320.
Article
10. McLean MM, Vert C, Dutcher M, Kollar R, Tilney PV. A 41-year-old man with an incomplete spinal cord injury. Air Med J. 2014; 33:6–9. PMID: 24373468.
Article
11. O'Neill S, McKinstry CS, Maguire SM. Unusual stab injury of the spinal cord. Spinal Cord. 2004; 42:429–430. PMID: 15007377.
12. Peacock WJ, Shrosbree RD, Key AG. A review of 450 stabwounds of the spinal cord. S Afr Med J. 1977; 51:961–964. PMID: 888030.
13. Pollard ME, Apple DF. Factors associated with improved neurologic outcomes in patients with incomplete tetraplegia. Spine (Phila Pa 1976). 2003; 28:33–39. PMID: 12544952.
Article
14. Ross ED, Kirkpatrick JB, Lastimosa AC. Position and vibration sensations: functions of the dorsal spinocerebellar tracts? Ann Neurol. 1979; 5:171–176. PMID: 426481.
Article
15. Roth EJ, Park T, Pang T, Yarkony GM, Lee MY. Traumatic cervical Brown-Sequard and Brown-Sequard-plus syndromes: the spectrum of presentations and outcomes. Paraplegia. 1991; 29:582–589. PMID: 1787982.
Article
16. Rubin G, Tallman D, Sagan L, Melgar M. An unusual stab wound of the cervical spinal cord: a case report. Spine (Phila Pa 1976). 2001; 26:444–447. PMID: 11224894.
17. Simpson RK Jr, Venger BH, Narayan RK. Treatment of acute penetrating injuries of the spine: a retrospective analysis. J Trauma. 1989; 29:42–46. PMID: 2911102.
18. Takemura S, Sasai K, Ohnari H, Ichikawa N, Akagi S, Iida H. Brown-Séquard-plus syndrome due to stab injury: a case report. Spinal Cord. 2006; 44:518–521. PMID: 16331310.
Article
19. Waters RL, Sie I, Adkins RH, Yakura JS. Motor recovery following spinal cord injury caused by stab wounds: a multicenter study. Paraplegia. 1995; 33:98–101. PMID: 7753576.
Article
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