Controversies in the differential diagnosis of Brown-Sequard syndrome due to cervical spinal disease from stroke: A case series

Köksal, Vaner; Yavaşı, Özcan

doi:10.1016/j.tjem.2017.05.002

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…Brown-Squared syndrome accounts for less than 5% of all cervical spine injuries, rarely caused by cervical disc disease. 13 A total of 74 cases were reported in English literature. The age range varies between 23 and 86 years, with a mean of 47.2.…”

Section: Discussionmentioning

confidence: 99%

“…9 As a result, many cases are misdiagnosed and treated as CVS events. 1,13 However, the absence of aphasia and fascial numbness or weakness could lower the expectation of it. Despite starting as mild symptoms, it will rapidly progress to unilateral limb weakness; Safwat et al reported that the degree of involvement differs between the upper and lower limbs in most reported cases.…”

Section: Discussionmentioning

confidence: 99%

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Traumatic Cervical Disc Herniation Manifesting as Brown-Sequard Syndrome: A Case Report

Mohamed Hazeem,

Nawaz,

Saleh Al-Blooshi

2023

JBMS

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Brown-Sequard syndrome (BSS) is an uncommon condition caused by a localized injury to one side of the spinal cord. It is rarely reported to present because of cervical disc herniation (CDH), especially as a result of 2 consecutive discs prolapse, with only 8 cases reported worldwide, 4 of which have the cervical disc levels of C5-C6, C6-C7 being affected just like the case we are presenting. A 45 years male had complained of left-sided body pain and numbness following a fall, his symptoms progressing over two weeks to left side hemiparesis and impaired sensation; MRI of C spine revealed C5-C6, C6- C7 disc prolapse with cord compression resulting in BSS. The patient was treated surgically by anterior cervical discectomy and fusion (ACDF) followed by physiotherapy. The patient showed complete recovery in terms of sensory and motor deficits in both the right and left upper and lower limbs. We are stressing the role of detailed history, comprehensive neurological examination, and proper imaging in the early diagnosis of BSS. Treatment with anterior surgical intervention is the recommended approach in most reported cases and is associated with an excellent prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Traumatic Cervical Disc Herniation Manifesting as Brown-Sequard Syndrome: A Case Report

Mohamed Hazeem,

Nawaz,

Saleh Al-Blooshi

2023

JBMS

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“…[1,8,12] Brown-Sequard syndrome caused by partial compression of cervical spinal cord may also be observed. [23] Fielding et al [15] described 35 patients with OO and detected radiographic instability in 27 of 35 patients. They performed successful posterior C1-C2 internal fixation and fusion to 26 of 27 patients with instability (Gallie type).…”

Section: Discussionmentioning

confidence: 99%

Hypertrophy of the transverse ligament caused by os odontoideum: a case report

Avnioğlu¹,

Köksal²,

Ertekın³

2017

Anatomy

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Os odontoideum is a small oval or round shaped bone fragment observed as the most common congenital anomaly of the odontoid process. Since it causes a slowly increasing mobility or instability in the atlanto-axial joint, sudden death, tetraplegia, chronic neck pain, headache, torticollis and myelopathy may develop. The spinal canal widens initially at the craniocervical junction and symptoms can occur at a very late stage. In this case, clinical complaints emerged after the age of 35. There was no other neurological finding and no history of recent trauma in this case presenting with severe neck pain. This case report shows how ligaments, the supporting connective tissue elements, can be thickened to maintain stability when the stability of the cervical spine is impaired. Since it may cause sudden death even when asymptomatic, it is important to recognize this pathology and to distinguish os odontoideum from odontoid fractures in trauma patients.

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“…In most patients, the symptoms were observed during their daily activities. Few of them had a history of minor traumas in the form of falling at the same level [8]. Written consent was taken from the patients for performing the appropriate surgical intervention.…”

Section: Case Presentationmentioning

confidence: 99%

“…Major traumatic injuries are usually accompanied by Horner's syndrome when traumas involve the cervical region [14] and usually require urgent surgical intervention for spinal cord decompression, removal of foreign objects, repair of the affected area, and preservation of the spinal cord in its correct position. On the other hand, micro-or non-traumatic injuries result from trivial traumas, physical activities, or hyperextension [8]. The definitive diagnostic tool for such cases is MRI, which demonstrates the etiology and extension of the lesion.…”

Section: Surgically Treatable Etiologies Of Bssmentioning

confidence: 99%

Non-traumatic Causes of Brown-sequard Syndrome: A Case Series and Clinical Update With Systematic Review

2021

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Background and Importance: Brown-Sequard Syndrome (BSS) is a rare neurological condition resulting from a hemisection injury to or unilateral compression on the spinal cord. The common causes of BSS that are amenable to be treated surgically can be divided into traumatic and non-traumatic injuries. Traumatic injuries are often reported as the main cause of BSS. However, non-traumatic injuries of the spinal cord are more seen in recent years. This study aims to classify and update surgically treatable causes of BSS. Case Presentation: Retrospective data of 17 patients operated for BSS between 2008 and 2020 were included. The long-term outcomes of these patients were evaluated. In addition, a comprehensive search in PubMed, Scopus, and CINAHL was conducted for the retrieval of all relevant studies. Results: Magnetic Resonance Image (MRI) of our patients revealed Cervical Disc Herniation (CDH), spinal canal stenosis with cervical spondylosis, epidural hematoma, and ossification of the posterior longitudinal ligament. The postoperative outcomes of our cases ranged from partial to complete recovery. While the patients with acute epidural hemorrhage achieved complete recovery after surgery, neurological deficits in the other patients, especially those with severe cervical spinal canal stenosis, persisted despite adequate surgical decompression. The systematic literature review revealed that CDH is the most common non-traumatic surgically treatable cause of BSS, followed by spinal cord herniation and spinal epidural hematoma. Conclusion: Non-traumatic injuries of the spinal cord accompanied by narrowed cervical spinal canal pathologies are prominent surgically treatable causes of BSS. Contrary to the definition made 100 years ago, BSS can occur spontaneously due to underlying pathologies rather than major traumatic injuries.

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Controversies in the differential diagnosis of Brown-Sequard syndrome due to cervical spinal disease from stroke: A case series

Cited by 5 publications

References 12 publications

Traumatic Cervical Disc Herniation Manifesting as Brown-Sequard Syndrome: A Case Report

Traumatic Cervical Disc Herniation Manifesting as Brown-Sequard Syndrome: A Case Report

Hypertrophy of the transverse ligament caused by os odontoideum: a case report

Non-traumatic Causes of Brown-sequard Syndrome: A Case Series and Clinical Update With Systematic Review

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