Brown–Séquard syndrome due to penetrating injury by an iron fence point

Abstract

Study design: Case report. Objectives: To present an unusual type of penetrating objects causing Brown-Séquard syndrome (BSS) and its clinical character. Setting: Department of Orthopaedic Surgery, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, PR China. Methods: A 54-year-old man fell from a height of 4 m onto an iron fence, and a sharp iron fence point penetrated the right side of his back. He developed left-sided BSS. Both X-ray film and computed tomography scanning of the thoracic spine showed a right vertebral plate of Th5 fracture and metal fragments inclining through the posterior and left lateral of the spinal canal. Emergency decompressive laminectomy and removal of the foreign metal piece were performed. No improvement in neurological function was observed 10 days after surgery, and thus hyperbaric oxygen treatment was initiated twice a day for the next 1 month. Results: Forty days after surgery, his bladder function returned to normal. The motor deficit had regressed and he could walk without assistance 70 days after the operation. One year later, his lower extremity functions recovered almost completely, except for slight numbness on the right side. Conclusion: As far as we know, on the basis of existing literature, the injury mechanism to BSS by a sharp iron fence point has not been reported so far. The satisfactory recovery after injury may in part be attributed to timely surgery and continuing hyperbaric oxygen treatment.

Laminectomy for Penetrating Spinal Cord Injury with Retained Foreign Bodies

“…Eventually, 23 articles 7–29 published between 1950 to 2021 involving 25 patients were included. Plus three cases presented in the current article, 28 patients with this kind of injury were analyzed (Table 1).…”

“…Eventually, 23 articles 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 published between 1950 to 2021 involving 25 patients were included. Plus three cases presented in the current article, 28 patients with this kind of injury were analyzed (Table 1 ).…”

Thoracic ossification of the ligamentum flavum causing Brown-Séquard syndrome: a case report and literature review

“…We reviewed cases of BSS caused by thoracic vertebral pathologies and their treatments reported from 1978 to 2021 14 – 44 ( Table 1 ). Among these 50 cases, the age at presentation ranged from 11 to 76 years (average, 45.9 years).…”

Brown-Séquard syndrome in a 11-year-old girl due to penetrating glass injury to the thoracic spine

“…Treatment for this disease should be the same as for other acute spinal cord injuries. Indication for surgical intervention in existing cerebrospinal fluid fistula includes closure of the dura and reducing neural elements compression and lowering the risk of infectious complications by removing bone or foreign body fragments or hematoma [ 9 , 10 ]. However, severe neurological deficits remaining unchanged from the time of injury rarely improve after decompressive surgery.…”