Brown-Sequard syndrome associated with a spinal cord injury caused by a retained screwdriver: A case report and literature review

Abstract

Background: Nonmissile penetrating spine injury (NMPSI) represents a small percent of spinal cord injuries (SCIs), estimated at 0.8% in Western countries. Regarding the causes, an NMPSI injury caused by a screwdriver is rare. This study reports a case of a retained double-headed screwdriver in a 37-year-old man who sustained a stab injury to the back of the neck, leaving the patient with a C4 Brown-Sequard syndrome (BSS). We discuss the intricacies of the surgical management of such cases with a literature review. Methods: PubMed database was searched by the following combined formula of medical subjects headings, (MESH) terms, and keywords: (((SCIs [MeSH Terms]) OR (nmpsi [Other Term]) OR (nonmissile penetrating spinal injury [Other Term]) OR (nonmissile penetrating spinal injury [Other Term])) AND (BSS [MeSH Terms])) OR (BSS [MeSH Terms]). Results: A total of 338 results were found; 258 were case reports. After excluding nonrelated cases, 16 cases were found of BSS induced by spinal cord injury by a retained object. The male-to-female ratio in these cases is 11:5, and ages ranged from 11 to 72. The causes of spinal cord injury included screwdrivers in three cases, knives in five cases, and glass in three cases. The extracted data were analyzed. Conclusion: Screwdriver stabs causing cervical SCIs are extremely rare. This is the first case from Iraq where the assault device is retained in situ at the time of presentation. Such cases should be managed immediately to carefully withdraw the object under direct vision and prevent further neurological deterioration.

Academic productivity of Iraqi medical students in the field of neurosurgery: A literature review

“…Table 1 shows the productivity of Iraqi medical students with their publications' number and type of authorship. [2][3][4][5][6][7][8][9][10][11][12][15][16][17][18][19][20][21][22][23][24][25]28,[31][32][33][34][35][36][37][39][40][41][42][43][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60]…”

“…Table 1 shows the productivity of Iraqi medical students with their publications’ number and type of authorship. [ 2 - 12 , 15 - 25 , 28 , 31 - 37 , 39 - 43 , 45 - 61 , 63 , 65 , 67 - 69 , 72 , 73 ]…”

“…Mustafa Ismail [2][3][4]6,7,9,12,16,24,32,[48][49][50][51][52][53][54][55][56]58,59,72] 22 9 first author\13 co-author Aktham O. Al-Khafaji [2,5,9,10,15,19,23,31,34,37,41,45,52,53,56] 15 3 first author\12 co-author Saja A. Albanaa [10,20,21,22,35,37,39,40,42,43,46] 11 1 first author\10 co-author Teeba A. Adnan [2,4,6,7,…”

Inner and outer penetrating spinal cord injuries lead to distinct overground walking in mice

“…Missile penetrating SCI is more frequent than non-missile SCI and gunshots were the most common cause ( Bin-Alamer et al, 2022 ). Non-missile penetrating SCI is rare, estimated at 0.8% in Western countries ( Abdulqader et al, 2022 ) and knife stabs were the most common cause of the non-missile SCI ( Bin-Alamer et al, 2022 ). Patients with penetrating SCI undergo surgical or conservative management.…”

Lesión traumática aguda de medula espinal. Presentación de una serie de casos clínicos y su abordaje quirúrgico

“…Un ejemplo de lesión medular incompleta, es el síndrome de Brown Séquard, que muestra una hemisección de la médula espinal, provoca debilidad y parálisis, además de pérdida de las sensaciones de dolor y temperatura en el lado opuesto (9) En cuanto al manejo, la función cardiovascular en pacientes con LMT, a menudo requiere el uso de agentes vasoactivos, para mejorar la presión arterial media, obtener un óptimo control de la misma y por consiguiente mejores resultados neurológicos (10). La estabilización temprana de los sistemas respiratorio, cardiovascular y la inmovilización de la columna cervical / toracolumbar, son necesarias para prevenir lesiones adicionales.…”