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Case Reports
. 2018 Oct 23:9:213.
doi: 10.4103/sni.sni_142_18. eCollection 2018.

A rare case of Brown-Sequard syndrome caused by traumatic cervical epidural hematoma

Samir Kashyap  1 , Gohar Majeed  1 , Shokry Lawandy  1
Affiliations
Case Reports

A rare case of Brown-Sequard syndrome caused by traumatic cervical epidural hematoma

Samir Kashyap et al. Surg Neurol Int. .

Abstract

Background: Brown-Sequard syndrome (BSS) is a well-known entity that is most commonly caused by a penetrating injury to the spinal cord (e.g., stab wound or gunshot wound). It is characterized by an ipsilateral weakness (damage to corticospinal tracts) and contralateral loss of pain and temperature two levels below the lesion (damage to lateral spinothalamic tracts). Although, rarely non-penetrating injuries, tumors, disc herniations, infections, autoimmune diseases, and epidural hematomas (non-penetrating trauma and spontaneous) have contributed to BSS syndromes, there are only four cases of BSS in the literature attributed to traumatic spinal epidural hematomas. Here, we add an additional case involving a 59-year-old male.

Case description: A 59-year-old male presented with a Brown-Sequard syndrome (BSS) after a motor vehicle accident. The magnetic resonance imaging (MRI) demonstrated a cervical epidural hematoma at the C7-T1 level. Following a T1 laminectomy and C6-T1 fusion, his neurological deficit markedly improved. Within six postoperative months, he regained full motor function.

Conclusion: For this patient and others with a traumatic cervical epidural hematoma (C7T1) resulting in a BSS, early decompression (within 48 hours) should result in marked postoperative neurological improvement.

Keywords: Brown-Sequard; cervical epidural hematoma; spinal trauma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Preoperative MRI cervical spine sagittal STIR (left) and axial T2 (right) showing dorsal epidural hematoma causing cord compression at C7–T1
Figure 2
Figure 2
Postoperative cervical spine AP/lateral XR showing C6–T1 fusion construct with lateral mass screws at C6 and T1 pedicle screws
See this image and copyright information in PMC

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