Torres Jose, Kim Kevin T, Yarmoska Steven K, Serra Riccardo, Crandall Kenneth M
Department of Neurosurgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas.
Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland.
J Neurosurg Case Lessons. 2024 Dec 23;8(26). doi: 10.3171/CASE24637.
Brown-Séquard syndrome (BSS) is a rare neurological condition characterized by injury to one-half of the spinal cord. In the context of trauma, BSS is typically seen with penetrating injuries. Here, the authors present the unique case of a patient presenting with BSS after blunt trauma.
A 70-year-old male with a history of right cervical hemilaminectomies from C4 to C6 and ossification of the posterior longitudinal ligament (OPLL) presented after a motor vehicle collision. He had left-sided weakness (American Spinal Injury Association [ASIA] grade C with a motor score of 45 and a neurological level of C4), left-sided sensory loss, and right-sided loss of sensation to painful stimulation. Magnetic resonance imaging revealed significant spinal cord compression from C2 to C6, with intramedullary signal from C2 to C5. The patient underwent urgent C2-6 laminectomies with C2-5 instrumented fusion. Intraoperative ultrasound confirmed complete decompression as well as visualized a hyperechoic signal, particularly in the left C3-4 hemicord, evident of spinal cord injury. Postoperatively, his ASIA motor score improved to 56 at the 6-week follow-up.
This case highlights a unique scenario in which prior decompressive surgeries could have provided a protective effect on the spinal cord at the levels with concomitant OPLL and hemilaminectomies, potentially preventing complete tetraplegia. https://thejns.org/doi/10.3171/CASE24637.
布朗 - 色夸综合征（Brown - Séquard syndrome，BSS）是一种罕见的神经系统疾病，其特征为脊髓的一半受到损伤。在创伤情况下，BSS通常见于穿透性损伤。在此，作者报告了一例钝性创伤后出现BSS的独特病例。
一名70岁男性，有C4至C6右侧颈椎半椎板切除术及后纵韧带骨化（ossification of the posterior longitudinal ligament，OPLL）病史，在机动车碰撞后就诊。他有左侧肢体无力（美国脊髓损伤协会[American Spinal Injury Association，ASIA] C级，运动评分45分，神经平面为C4）、左侧感觉丧失以及右侧痛觉刺激感觉丧失。磁共振成像显示C2至C6脊髓明显受压，C2至C5髓内有信号改变。患者接受了紧急的C2 - 6椎板切除术及C2 - 5器械辅助融合术。术中超声证实完全减压，并可视化了一个高回声信号，特别是在左侧C3 - 4半脊髓，提示脊髓损伤。术后6周随访时，他的ASIA运动评分提高到了56分。
该病例突出了一种独特的情况，即先前的减压手术可能对伴有OPLL和半椎板切除术的脊髓节段起到了保护作用，有可能预防完全性四肢瘫。https://thejns.org/doi/10.3171/CASE24637 。
