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David Z Cai, Geoffrey Liu, Christopher F Wolf, Zachary M Mansell, Jonathan P Eskander, Mark Eskander
Brown-Séquard syndrome, while uncommon, is a neurological condition that classically results from the hemisection of the spinal cord as a result of a penetrating injury to the spinal cord. We present a reported case of blunt trauma causing a high-energy cervical burst fracture/dislocation with a significant cord signal change producing Brown-Séquard syndrome. In this case, the burst fracture at the level of C5 obtained from the motor vehicle accident led to the damage of the left-sided lateral spinal thalamic tract, descending lateral cortical spinal tracts, and ascending dorsal column...
January 2018: Asian Journal of Neurosurgery
Michael G Z Ghali, Visish M Srinivasan, Vikas Y Rao, Ibrahim Omeis
Idiopathic spinal cord herniation represents an uncommon and unique diagnostic entity, most commonly affecting middle-aged individuals, with a nearly twofold female predilection. It most characteristically affects the mid-thoracic spine, with the herniation occurring ventrally or ventrolaterally. Clinical presentation is typically a slowly-progressive myelopathy, with Brown-Séquard syndrome occurring more frequently than spastic paraparesis. Diagnosis is made by imaging, with high-resolution or phase-contrast MR sequences and/or CT myelography...
February 19, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Quentin Mathais, Pierre Esnault, Maximilien Cruc, Cedric Bernard, Bertrand Prunet, Pierre Emmanuel Gaillard
BACKGROUND: While spontaneous spinal epidural hematomas are rare, one of the identified risk factors is vitamin K antagonist therapy. CASE DESCRIPTION: We present a case of a spontaneous spinal epidural hematoma occurring in a patient under treatment with dabigatran, a non-vitamin K oral anticoagulant. The initial hemiparesis symptom was misleading and was retrospectively identified as Brown Sequard syndrome. Immediate dabigatran antagonism with idarucizumab followed by posterior cervical laminectomy permitted a complete neurological recovery at day 4...
February 6, 2018: World Neurosurgery
Akhila Reddy, Amy Ng, Tarun Mallipeddi, Eduardo Bruera
Neuropathic pain in cancer patients is often difficult to treat, requiring a combination of several different pharmacological therapies. We describe two patients with complex neuropathic pain syndromes in the form of phantom limb pain and Brown-Sequard syndrome who did not respond to conventional treatments but responded dramatically to the addition of levorphanol. Levorphanol is a synthetic strong opioid that is a potent N-methyl-d-aspartate receptor antagonist, mu, kappa, and delta opioid receptor agonist, and reuptake inhibitor of serotonin and norepinephrine...
January 29, 2018: Journal of Palliative Medicine
Ravish Patel, Aravind Kumar, Kazuya Nishizawa, Naresh Kumar
Spontaneous spinal epidural haematoma (SSEH) is a rare condition that requires urgent surgical intervention in order to prevent permanent neurological deficit. SSEH commonly presents as a paraparesis or tetraparesis. SSEH presenting as a hemiparesis is less common and in such situations, it can be mistaken for a cerebrovascular accident (CVA). Thrombolytic or anticoagulant treatment for CVA can potentially worsen the neurological deficit. We report one such case of SSEH misdiagnosed as a CVA. Treatment with tissue plasminogen activator led to worsening of his condition...
January 26, 2018: BMJ Case Reports
Kaili Du, Zhenkai Lou, Chunqiang Zhang, Peiyu Guo, Lingqiang Chen, Bing Wang, Dongsheng Huang
BACKGROUND: Spinal osteochondroma is a rare but recognized cause of myelopathy. Brown-Sequard syndrome is a form of severe myelopathy characterized by a clinical picture of hemisection of the spinal cord. Brown-Sequard syndrome caused by osteochondroma is extremely rare, calling for individualized surgical procedures. CASE DESCRIPTION: We reveal a 16-year-old girl with hereditary multiple exostoses as a rare case of thoracic osteochondroma causing partial Brown-Sequard syndrome...
December 16, 2017: World Neurosurgery
Anthea H O'Neill, Teik Beng Phung, Leon T Lai
Intramedullary spinal cord metastasis (ISCM) is rare and occurs most commonly in the setting of advanced malignancy. The optimal management pathways are not well defined and treatment outcomes from contemporary therapies remain variable. We report a case of a 49-year-old woman with known primary papillary thyroid carcinoma, who presented with rapidly progressive clinical features of Brown-Sequard syndrome. A detailed pooled analysis of the literature was conducted to characterise the clinical and demographic features, management options, and expected survival outcomes for cases of ISCM...
December 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Dong-Yeong Lee, Soon-Taek Jeong, Tae-Ho Lee, Dong-Hee Kim
Brown-Sequard syndrome is an uncommon complication of atlantoaxial arthrodesis. A 50-year-old female visited our emergency department after falling from a ladder. Radiologic evaluations revealed chronic C1-2 instability with acute spinal cord injury. The day after atlantoaxial fusion was performed, she developed left-sided motor weakness and the loss of right-sided pain and temperature sensation. Based on physical examination and radiologic findings, we diagnosed her as having Brown-Sequard syndrome. Spine surgeons performing this procedure should therefore consider Brown-Sequard syndrome if a patient displays signs of postoperative hemiplegia...
November 23, 2017: Acta Orthopaedica et Traumatologica Turcica
Qing Guan, Fei Xing, Ye Long, Zhou Xiang
BACKGROUND: Cervical intradural disc herniation (CIDH) is rare, and diagnosis and treatment are challenging. We conducted a systematic review and meta-analysis of the literature on the diagnosis and treatment of CIDH. METHOD: The presentation, imaging manifestations, diagnosis, management, prognosis and possible pathogenesis were reviewed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English-language studies and case reports published from inception to 2017 were retrieved...
November 18, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jingzhe Han, Duanhua Cao, Guomei Ma, Tingting Wang, Ye Ji, Zhilei Kang
RATIONALE: Patients with Klippel-Feil syndrome (KFS) are always anomaly associated with vertebrobasilar dysplasia. That may present commonly as infarction of brainstem, medulla, and cerebellum. In this article, we reported a rare case of lateral medullary infarction (LMI) with similar features of Brown Sequard syndrome caused by vertebrobasilar dysplasia and KFS, and the 2 rare conditions that are causally related. The case is being reported because of its unusual and rare presentation...
November 2017: Medicine (Baltimore)
Thorbjorn Loch-Wilkinson, Stephen McNeil, Chris White, Christiaan Schrag, Rajiv Midha
No abstract text is available yet for this article.
November 9, 2017: World Neurosurgery
Fernando Rascón-Ramírez, Josué M Avecillas-Chasín, Albert Trondin, M Javier Arredondo
Cervical Traumatic SSH are very rare in literature. They are usually caused by cardiopulmonary diseases that increase vascular pressure causing spinal vessels rupture. In thoracolumbar spine, the spinal puncture is the most common cause. The ventrolateral position is even more unusual. In traumatic brain injury (TBI), an abrupt extension-flexion movement could have caused the rupture of subarachnoid vessels. This, accompanied by the slowed blood "wash out" (probably due to the previous osteoarthrosis and spinal canal stenosis), led to the formation of an organized clot, which caused an acute spinal cord compression syndrome...
October 20, 2017: Neurocirugía
Michael J Aminoff
No abstract text is available yet for this article.
May 1, 2017: Brain: a Journal of Neurology
Arunprasad Gunasekaran, Nova Kristine M de Los Reyes, Jerry Walters, Noojan Kazemi
OBJECTIVE: Spontaneous cervical intradural disc herniation (IDH) is a rare occurrence with limited and disparate information available regarding its presentation, diagnosis, and treatment. However, its accurate detection is vital for planning surgical treatment. In this review of the literature, we collected data from all cervical intradural disc herniations described to date. Particular attention is paid to diagnostic findings, surgical approach and causation for cervical IDH, especially at the cervicothoracic junction...
October 7, 2017: World Neurosurgery
Y Ronzi, B Perrouin-Verbe, O Hamel, R Gross
OBJECTIVES: To specify outcomes and identify prognostic factors of neurologic and functional recovery in patients with an acute traumatic spinal cord injury (SCI) associated with cervical spinal canal stenosis (SCS), without spinal instability. METHODS: A retrospective study was conducted using data from a Regional Department for SCI rehabilitation in France. A description of the population characteristics, clinical data and neurological and functional outcomes of all patients treated for acute SCI due to cervical trauma associated with SCS was performed...
October 6, 2017: Annals of Physical and Rehabilitation Medicine
Vaner Koksal, Ozcan Yavasi
Stroke is generally considered to be the first preliminary diagnosis in patients presenting with acute hemiparesia in the emergency department. But rarely in unexpected spontaneous neurological pathologies that may lead to hemiparesis. The data from 8 non-traumatic patients who underwent surgical treatment for brown-sequard syndrome (BSS) were reviewed retrospectively. All patients were initially misdiagnosed with strokes. Two of the patients had spinal canal stenosis, two had spinal epidural hematomas, one had an ossified herniated disc and three had soft herniated discs...
September 2017: Turkish Journal of Emergency Medicine
Tarun Kumar Ralot, Rambir Singh, Chander Bafna, S Rajesh, Surender Singh
A female patient aged 48 years presented with sub-acute onset of weakness in right upper and lower limb over the past one month and numbness over left side of body below neck level. Multiple sclerosis (MS) presenting as Brown-Séquard syndrome is very rare. We present a case of hemicord myelitis which presented as Brown-Séquard syndrome as a first manifestation, which was later diagnosed as MS during subsequent relapses.
August 2017: Malaysian Journal of Medical Sciences: MJMS
Grayson Beecher, Trevor Kotylak, Wendy S Johnston
No abstract text is available yet for this article.
May 23, 2017: Neurology
Allen R Wolfe, Raihan M Faroqui, George A Visvikis, Michael T Mantello, Allan B Perel, Sanjit O Tewari
Dabigatran etexilate is a relatively new anticoagulant from the class of direct thrombin inhibitors which is administered orally and does not require routine blood work monitoring. Dabigatran may be attractive to both clinicians and patients because of both its convenience and efficacy; however, clinical complications are still being elucidated. Here, we present a previously unreported case of spinal subarachnoid and subdural hematoma presenting as a Brown-Séquard-like myelopathy in a patient after minor trauma in the setting of Dabigatran anticoagulation...
June 2017: Radiology Case Reports
Irene Baudracco, Gordan Grahovac, Vittorio M Russo
PURPOSE: Cervical spontaneous intradural disc herniation (IDH) is an extremely rare condition. We describe a unique case of a patient presenting with a Brown-Séquard syndrome (BSS) and Horner's syndrome (HS). This study aimed to report an unusual case of spontaneous cervical intradural disc herniation that presented with Horner's and Brown-Séquard syndrome (BSS) and discuss difficulties in preoperative diagnosis and treatment difficulties of intradural cervical disc. METHODS: Notes and images review, and analysis of the relevant literature...
May 2017: European Spine Journal
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