Penetrating spinal cord injury with screwdriver in situ, leading to Brown-Sequard syndrome

Meena, Ugan Singh; Kataria, Rashim; Sharma, Kanchan; Sardana, V.

doi:10.4103/0976-3147.178664

Cited by 4 publications

(4 citation statements)

References 10 publications

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“…According to Meena et al ., the literature only documents five cases of BSS in the setting of retained foreign material in penetrating SCIs, with their case being the sixth reported up to the time of its publication. [ 25 ] Three of the cases were due to screwdriver injury, and only one case involved the cervical spine. All cases were managed immediately, and surgical exploration to remove the retained object was the established practice.…”

Section: Discussionmentioning

confidence: 99%

“…Meena et al, 2016 [25] 20/M BSS T12 Screwdriver Surgical intervention for the retrieval of the screwdriver Improvement Jesmanas et al, 2018 [14] 50/M Weakness and sensory loss in the lower limb C6-C7 Glass chip Conservative treatment due to the risks of surgery Slight improvement in motor function.…”

Section: No Improvementmentioning

confidence: 99%

“…[ 4 , 12 , 29 , 35 ] Brown-Sequard syndrome (BSS) is a pattern of incomplete SCI where hemisection of the spinal cord manifests as ipsilateral paresis and loss of vibration and proprioception at the level of injury, with contralateral loss of pain and temperature sensation 2–3 levels below the injury. [ 1 , 25 ] It represents about 17% of incomplete cord injuries. [ 24 ] Patients with traumatic BSS generally have the best outcomes of any type of SCI, and 75–90% of those patients ambulate within 1 month of inpatient rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

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Brown-Sequard syndrome associated with a spinal cord injury caused by a retained screwdriver: A case report and literature review

Abdulqader

Ismail

Al-Khafaji

et al. 2022

Surgical Neurology International

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Background: Nonmissile penetrating spine injury (NMPSI) represents a small percent of spinal cord injuries (SCIs), estimated at 0.8% in Western countries. Regarding the causes, an NMPSI injury caused by a screwdriver is rare. This study reports a case of a retained double-headed screwdriver in a 37-year-old man who sustained a stab injury to the back of the neck, leaving the patient with a C4 Brown-Sequard syndrome (BSS). We discuss the intricacies of the surgical management of such cases with a literature review. Methods: PubMed database was searched by the following combined formula of medical subjects headings, (MESH) terms, and keywords: (((SCIs [MeSH Terms]) OR (nmpsi [Other Term]) OR (nonmissile penetrating spinal injury [Other Term]) OR (nonmissile penetrating spinal injury [Other Term])) AND (BSS [MeSH Terms])) OR (BSS [MeSH Terms]). Results: A total of 338 results were found; 258 were case reports. After excluding nonrelated cases, 16 cases were found of BSS induced by spinal cord injury by a retained object. The male-to-female ratio in these cases is 11:5, and ages ranged from 11 to 72. The causes of spinal cord injury included screwdrivers in three cases, knives in five cases, and glass in three cases. The extracted data were analyzed. Conclusion: Screwdriver stabs causing cervical SCIs are extremely rare. This is the first case from Iraq where the assault device is retained in situ at the time of presentation. Such cases should be managed immediately to carefully withdraw the object under direct vision and prevent further neurological deterioration.

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Section: Discussionmentioning

confidence: 99%

Section: No Improvementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Brown-Sequard syndrome associated with a spinal cord injury caused by a retained screwdriver: A case report and literature review

Abdulqader

Ismail

Al-Khafaji

et al. 2022

Surgical Neurology International

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“…Screwdriver-induced PBI is severe and neglected [4, 5]. First, due to their length and spiral force, the tip of rigid screwdrivers may be enable to penetrate into the calvarium, and once through the bone, the screwdrivers may pivot around the entry point in the skull and then cause curved intracranial injuries, which are far more serious than the damage of skin surface.…”

Section: Introductionmentioning

confidence: 99%

Management of screwdriver-induced penetrating brain injury: a case report

et al. 2017

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BackgroundPenetrating brain injury (PBI) can be caused by several objects ranging from knives to chopsticks. However, an assault with long and electric screwdriver is a peculiar accident and is relatively rare. Because of its rarity, the treatments of such injury are complex and nonstandardized.Case presentationWe presented a case of a 54-year-old female who was stabbed with a screwdriver in her head and accompanied by loss of consciousness for 1 h. Computer tomography (CT) demonstrated that the screwdriver passed through the right zygomatic bone to posterior cranial fossa. Early foreign body removal and hematoma evacuation were performed and the patient had a good postoperative recovery.ConclusionsIn this study, we discussed the clinical presentation and successful management of such a unique injury caused by a screwdriver. Our goal is to demonstrate certain general management principles which can improve patient outcomes.

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Management of non-missile penetrating spinal injury

Wallace

Peitz

et al. 2018

Neurosurg Rev

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Penetrating spinal cord injury with screwdriver in situ, leading to Brown-Sequard syndrome

Cited by 4 publications

References 10 publications

Brown-Sequard syndrome associated with a spinal cord injury caused by a retained screwdriver: A case report and literature review

Brown-Sequard syndrome associated with a spinal cord injury caused by a retained screwdriver: A case report and literature review

Management of screwdriver-induced penetrating brain injury: a case report

Management of non-missile penetrating spinal injury

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