Herr R D, Barrett J
Division of Emergency Medicine, McGaw Medical Center, Northwestern University, Chicago, Illinois 60611.
Ann Emerg Med. 1987 Nov;16(11):1285-8. doi: 10.1016/s0196-0644(87)80241-x.
We report the case of a man with Brown-Sequard syndrome following a fall in which he sustained fractures of the thoracic and lumbosacral spine. Despite characteristic neurological findings, the diagnosis was delayed due to the absence of history of penetrating spinal trauma and incorrect attribution of unilateral-like weakness and numbness to lumbosacral trauma. A directed history and examination revealed that the patient was stabbed in the back with a penknife while leaving a bus and stepped down onto a paralyzed leg, which collapsed beneath him. The patient was given an antibiotic, underwent a negative peritoneal lavage, and had myelography and nerve conduction velocity confirmatory for Brown-Sequard syndrome. With rehabilitation he became ambulatory with a cane one month after the stabbing.
我们报告一例因跌倒导致胸腰椎和腰骶椎骨折后出现布朗 - 色夸综合征的男性病例。尽管有典型的神经学表现，但由于缺乏穿透性脊柱创伤史，且将单侧性肌无力和麻木错误归因于腰骶部创伤，诊断被延迟。详细的病史询问和体格检查发现，患者在下车时被一把小折刀刺伤背部，然后踩在一条瘫痪的腿上，那条腿在他身下塌陷。患者接受了抗生素治疗，腹膜灌洗结果为阴性，并进行了脊髓造影和神经传导速度检查，结果证实为布朗 - 色夸综合征。刺伤一个月后，经过康复治疗，患者能够拄着拐杖行走。
