Síndrome de Brown-Séquard como forma de presentación de mielitis transversa idiopática / Brown-Séquard syndrome as a presentation of idiopathic transverse myelitis

El síndrome de Brown-Séquard es el conjunto de signos y síntomas causado por hemisección medular de diversos orígenes. Puede generarse por múltiples causas; las traumáticas son las más frecuentes. Las causas menos frecuentes son patología inflamatoria, isquémica, tumoral o infecciosa. Se presenta un niño de 12 años, con instauración aguda y progresiva de un síndrome de hemisección medular derecho, con parálisis hipo/arrefléctica homolateral y afectación de sensibilidad termoalgésica contralateral. En la resonancia magnética de médula espinal, se observó compromiso inflamatorio en hemimédula derecha a nivel de segunda y tercera vértebras torácicas. Con diagnóstico de mielitis transversa idiopática, inició tratamiento con corticoide intravenoso a altas dosis con evolución clínica favorable y restitución de las funciones neurológicas.

Brown-Séquard syndrome refers to a set of signs and symptoms caused by hemisection of the spinal cord from various sources. It may have multiple causes; traumatic injuries are the most frequent ones. The less common causes include inflammation, ischemia, tumors, or infections. This report is about a 12-year-old boy with an acute and progressive course of right hemisection of the spinal cord, with ipsilateral hypo/areflexic paralysis and contralateral loss of thermalgesic sensation. The MRI of the spinal cord showed inflammation in the right side of the spinal cord at the level of the second and third thoracic vertebrae. The patient was diagnosed with idiopathic transverse myelitis and was started on intravenous high-dose corticosteroids; he showed a favorable clinical course and recovered neurological functions.

Stab wound in cervical spine causing Brown-Séquard syndrome: case report

Introduction: To report a case of cervical spinal cord injury due to stab wounds, with the development of the Brown-Séquard syndrome. Methods: We analyzed clinical and imaging, as well as conduits for the case of a 22 year-old man, victim of physical aggression by stab wound in the neck. Results: Tetraparesis, contralateral deficit of thermal and pain sensitivities below the lesion and ipsilateral motor and proprioception deficits are justified by the findings on imaging studies. A CT scan of the cervical spine revealed a hyperdense lesion between C3-C4. The MRI, in turn, showed the presence of right paravertebral hematoma and partial spinal cord injury between C3 and C4. The moderate neurological deficit persisted at discharge from hospital. Conclusion: Spinal cord injuries due to stab wounds are uncommon when compared to those caused by other factors such as traffic accidents, falls and gunshot injury. The neurological presentation of Brown-Séquard syndrome has been reported as rare in medical literature. Its treatment in most cases is conservative and the prognosis is better when it comes from stab injury rather than other causes.

Hernia medular espontanea: reporte de un caso. Revision de la literatura y teoria sobre las imagenes de IRM postoperatorias / Spontaneous spinal cord hernia. Case report, literature review and a theory about post operative MRI

Objective: to describe a new case of idiopathic spinal cord herniation. Description: a 34 year-old male patient had during the last 5 years a progressive Brown-Sequard syndrome. MRI showed ventral displacement of the spinal cord at T7-T8 and widening of the posterior subarachnoid space. Intervention: a laminectomy was performed with reduction of the herniated cord and closure of the dural defect with a graft. Postoperative outcome was uneventful and the patient improved neurologically. Control MRI showed hyperintense cord signals at the level of the previous herniated level. Conclusion: surgery with reduction of the hernia and dura closure provided symptomatic improvement. Postoperative MRI cord hyperintense signals may correspond to syringomyelia