Clin Exp Emerg Med.  2019 Sep;6(3):268-271. 10.15441/ceem.19.010.

Unilateral loss of thoracic motion after blunt trauma: a sign of acute Brown-Séquard syndrome

• Sato M
• Kuriyama A
• Ohtomo R

• KMID: 2459807
• DOI: http://doi.org/10.15441/ceem.19.010

Abstract

Late-onset Brown-Séquard syndrome (BSS) is a rare condition resulting from a spinal cord injury that develops weeks to years after a blunt trauma. Acute-onset BSS after a blunt injury has been rarely reported. Here, we report on a case of BSS, in a 58-year-old man, that developed immediately after a motor vehicle accident. Upon admission, loss of right thoracic motion, complete right paresis, and loss of pain and temperature sensations below the C3 level on the left side were observed. Magnetic resonance imaging showed hyperintensities within the cervical spinal cord at the C2-C3 level, confirming the diagnosis of BSS. Thoracic motion rapidly recovered, but other neurological sequelae persisted. BSS related to cervical cord injury should be suspected when patients develop hemiparesis and contralateral sensory loss immediately after a blunt trauma. Likewise, clinicians should be aware that unilateral loss of thoracic motion could be an important sign of BSS.

Keyword

Thoracic motion; Wounds, nonpenetrating; Brown-Sequard syndrome; Spinal cord injuries; Paresis

MeSH Terms

Brown-Sequard Syndrome
Cervical Cord
Diagnosis
Humans
Magnetic Resonance Imaging
Middle Aged
Motor Vehicles
Paresis
Sensation
Spinal Cord Injuries
Wounds, Nonpenetrating