Conservative Management of Traumatic Brown-Séquard Syndrome: A Case Report
Autor: | Abdulrahman H Zekry, Ayat A Yousef, Ghada A Alskait, Abdulaziz Alrabiah, Trad S Alwakeel |
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Rok vydání: | 2021 |
Předmět: |
Adult
Male Weakness medicine.medical_specialty Brown-Séquard syndrome Wounds Stab Conservative Treatment Brown-Sequard Syndrome medicine Paralysis Humans Spinal cord injury Spinal Cord Injuries Cerebrospinal fluid leak business.industry Glasgow Coma Scale General Medicine Hypoesthesia Articles medicine.disease Spinal cord Magnetic Resonance Imaging Surgery medicine.anatomical_structure medicine.symptom Brown-Séquard Syndrome business |
Zdroj: | The American Journal of Case Reports |
ISSN: | 1941-5923 |
Popis: | Patient: Male, 33-year-old Final Diagnosis: Traumatic Brown-Séquard syndrome Symptoms: Bilateral lower limb weakness • contralateral (right) hypoesthesia from the level of the nipple below • knee and ankle jerks both were 2 on the right side and 0 on the left Medication: — Clinical Procedure: Magnetic resonance imaging (MRI) of the cervical and thoracic spine • whole-body computed tomography (CT) Specialty: Surgery Objective: Unusual clinical course Background: Traumatic spinal cord injuries are quite common; however, a rare form of incomplete spinal cord injury is Brown-Séquard syndrome. Brown-Séquard syndrome is defined by the National Institute of Neurological Disorders and Strokes as “a rare neurological condition characterized by a lesion in the spinal cord which results in weakness or paralysis (hemiparaplegia) on one side of the body and a loss of sensation (hemianesthesia) on the opposite side.” Case Report: A 33-year-old man was brought to the Emergency Department by Saudi Red Crescent with multiple stab wounds on the left upper thoracic and lower cervical regions. He was tachycardic, but otherwise vitally stable. His Glasgow Coma Scale score was 15. The patient presented with bilateral lower limb weakness, more on the ipsilateral (left) side, and contralateral (right) hypoesthesia from the level of the nipple below. Cervical and thoracic magnetic resonance imaging revealed ligamentous injury defect at the posterior dura and indicating a dural tear with minor cerebrospinal fluid leak. Focal hyperintense signal intensity was noted on the left side of the spinal cord, representing contusion. The patient was managed conservatively with daily physical therapy. Strength had improved substantially by the time of discharge and sensation was improving. Conclusions: Brown-Séquard syndrome is associated with good prognosis. These patients require a multidisciplinary approach because it provides the best chance of recovery to pre-injury status. These injuries may cause disastrous neurological deficits; therefore, preventive strategies should be designated to decrease the incidence of such injuries. |
Databáze: | OpenAIRE |
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