1.08.2013

Brown-Sequard syndrome

Brown-Sequard... Jekyll-Hyde.... that's kind of how I remember what it is. Two different sides to the spinal cord, one good (uninjured) and one bad (injured). Brown-Sequard syndrome is characteristically seen in penetrating injuries (but can be seen in unilateral blunt injuries as well). The syndrome results in one side of the spinal cord being injured.

What do you see clinically?
Motor, position, and vibration are gone on the SAME side as the injured spinal cord (these tracts cross at the brainstem)
Pain and temperature are gone on the OPPOSITE side of the injured spinal cord (these tracts cross at the cord at or near the level of innervation)

http://nhananhana.wordpress.com/2010/01/28/brown-sequard-syndrome/
What to do clinically?
The diagnosis is generally made clinically based on hx and physical. This warrants a neurosurgical or orthopedic consult and MRI if requested. Lastly, studies have shown that high doses of steriods (methylprednisolone) decreases inflammation by suppressing polymorphonuclear leukocytes and reversing increased capillary permeability.




Sources: 
1.http://emedicine.medscape.com/article/791539-workup#a0720
2.Abernathy's Surgical Secrets by Harken and Moore

No comments:

Post a Comment