Trauma vértebro medular por arma blanca y síndrome de Brown Sequard: a propósito de un caso / Spinal cord injury by a stab wound and Brown Séquard syndrome: case report

RESUMEN

Introducción: El Síndrome de Brown Sequard a consecuencia de la lesión de la hemimédula espinal producida por arma blanca es poco frecuente. Reportamos un caso de este síndrome en su forma clásica. Caso Clínico Paciente varón de 18 años, sufre trauma penetrante con arma blanca en región cervical derecha, presentando hemiparesia ipsilateral, trastorno de propiocepción ipsilateral y termoalgésica contralateral. Los estudios mostraron una fractura laminar C6 derecha y edema medular en dicho nivel. Fue sometido a hemilaminectomia C6. Al tercer mes postoperatorio mejora el déficit neurológico. Conclusiones: El síndrome de Brown Sequard en su forma clásica o "pura" y producida por arma blanca es raro. El estudio mandatorio en este síndrome es la resonancia magnética nuclear. El tratamiento quirúrgico debe ser inmediato solo si hay evidencia de fragmento óseo, metálico o hematoma en el canal medular.

ABSTRACT

Introduction: It is unusual to observe the occurrence of Brown Séquard syndrome as a consequence of a lateral hemisection of the spinal cord caused by a stab wound. We report a case of this syndrome showing its typical presentation. Clinical Case A male, 18-year old subject was attacked and suffered a stab wound in his right cervical area. The patient developed ipsilateral hemiparesis, an ipsilateral proprioception disturbance and acontralateral thermo-algesic disturbance. Image studies showed a laminar fracture in C6 and spinal edema in the same area. The patient underwent a C6-laminectomy. Three months after surgery, his neurological condition improved. Conclusions: It is unusual to observe the occurrence of Brown Séquard syndrome in its so-called classical or 'pure' form caused by a stab wound. The mandatory image study to perform in these cases is magnetic resonance imaging. Surgical therapy should be immediately performed only if there is evidence of a bone or metal fragment in the spinal canal, or if there is a hematoma in this area.