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Brown-Sequard syndrome

Brown-Séquard syndrome, also known as Brown-Séquard's hemiplegia and Brown-Séquard's paralysis, is a loss of motricity (paralysis and ataxia) and sensation caused by the lateral hemisection of the spinal cord. Other synonyms are crossed hemiplegia, hemiparaplegic syndrome, hemiplegia et hemiparaplegia spinalis and spinal hemiparaplegia. more...

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Its symptoms include same-side loss of motor control, fine touch and sensation of vibration; and opposite-side loss of sensation of temperature (thermoanesthesia) and pain (analgesia).

It was first described in 1850 by the British neurologist Charles Édouard Brown-Sequard (1817-1896), who studied the anatomy and physiology of the spinal cord.

Reference

  • C.-E. Brown-Séquard: De la transmission croisée des impressions sensitives par la moelle épinière. Comptes rendus de la Société de biologie, (1850)1851, 2: 33-44.

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Conservative treatment of acute upper cervical spine injuries
From Journal of Bone and Joint Surgery, 1/1/03 by Papadopoulos, A X

Purpose: We present the midterm results of conservative treatment of upper (atlas and axis) cervical spine injuries and we propose a CT-based radiological follow-up study.

Material and Methods: In a 12 year period (1990-2001), 45 patients (33 male and 12 female) with a mean age 37.2 years (range 15-75) were presented with an acute injury of the upper cervical spine. There were 19 fractures of the atlas (8 Jefferson's fractures, 6 isolated lateral mass fractures and 5 posterior arch fractures) and 26 axial fractures (12 odontoid fractures, types I-III according to Anderson's classification and 14 traumatic spondylolisthesis, types I-II according to Effendi classification). Twenty (20) patients were immobilized using halo-vest and 25 Minerva orthosis. Two (2) patients presented with Brown-Sequard syndrome. All patients were retrospectively reviewed and had clinical and radiological follow-up study (plain films and CT spiral reconstruction films).

Mean follow-up was 6.2 years. Mean immobilization time was 3.8 months range.

Results: Patients with incomplete neurological lesion did not recover. One patient with an isolated atlas lateral mass fracture, developed a hemiparesis during his hospitalization, which was partially resolved. In the final follow-up study, all patients presented a stable upper cervical spine, on the dynamic flexion/extension plain films. In the final CT spiral reconstruction films, fracture line was evident in 12 patients (27%), while atlantoaxial joint incongruity was obvious in 5 patients. Seven (7) patients (16%) complained for residual neck pain and stiffness and presented reduced range of motion.

Conclusion: Conservative treatment of atlantoaxial injuries is effective and offers a stable upper cervical spine. Solid fracture union is not always present. CT spiral reconstruction is very helpful in detecting transverse ligament efficacy and atlantoaxial joint incongruity.

A.X. Papadopoulos, A. Panagopoulos, M. Papas, E. Tsota, C. Kalogeropoulou, P. Zouboulis, E. Lambiris

Dept. of Orthopaedics, Patras University, Patra. Dept. of Radiology Patras University, Patra.

Copyright British Editorial Society of Bone & Joint Surgery 2003
Provided by ProQuest Information and Learning Company. All rights Reserved

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