II. Epidemiology

  1. Uncommon Spinal Injury, accounting for only 4% of spinal cord injuries per year in the U.S.

III. Pathophysiology

  1. Hemisection of the spinal cord most affects the posterior cord
  2. Unilateral (hemi-cord) cord injury affecting the dorsal columns, Corticospinal tract and Spinothalamic Tract
  3. Spinothalamic Tract crosses to the contralateral side (giving the crossed effects)
  4. Images
    1. CordSyndrome.jpg

IV. Causes

  1. Penetrating Trauma (most common)
  2. Vertebral Fracture with lateral cord compression
  3. Blunt Spinal Cord Injury
  4. Disc Herniation
  5. Epidural Hematoma
  6. Decompression Sickness complication

V. Signs

  1. Ipsilateral motor weakness
  2. Ipsilateral proprioception and vibratory Sensation loss below the lesion
  3. Contralateral pain and TemperatureSensation loss starting two levels below the lesion

VI. Associated Conditions

VII. Management

  1. Consult neurosurgery for possible decompression surgery
  2. Avoid Corticosteroids (not recommended)

VIII. Prognosis

  1. Brown-Sequard Syndrome has an overall good prognosis
  2. Motor function is recovered in more than half of cases

IX. References

  1. Decker in Chorley and Bachur (2014) Overview of Cervical Spinal Cord Injuries..., UpToDate, Wolters-Kluwer
  2. Rodriguez, Winger, Poulo and Glunk (2023) Crit Dec Emerg Med 37(3): 23-9
  3. Wagner (1997) Emerg Med Clin North Am 15:699-711 [PubMed]

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Related Studies

Ontology: Brown-Sequard Syndrome (C0242644)

Definition (MSHCZE) Soubor příznaků, které se vyvinou po hemisekci míchy protětí její levé nebo pravé poloviny či při útlaku její poloviny. Pacient trpí stejnostrannou poruchou hybnosti a vibračního a diskriminačního čití a poruchou citlivosti pro bolest, teplo a chlad na straně opačné. (Velký lékařský slovník online, 2012 http://lekarske.slovniky.cz/ )
Definition (NCI) A disorder caused by a spinal injury leading to an incomplete spinal lesion. Patients develop paralysis, ataxia and loss of sensation. Causes include spinal cord tumors, spinal traumas, ischemia, and inflammatory processes affecting the spine.
Definition (MSH) A syndrome associated with injury to the lateral half of the spinal cord. The condition is characterized by the following clinical features (which are found below the level of the lesion): contralateral hemisensory anesthesia to pain and temperature, ipsilateral loss of propioception, and ipsilateral motor paralysis. Tactile sensation is generally spared. (From Adams et al., Principles of Neurology, 6th ed, p162).
Concepts Disease or Syndrome (T047)
MSH D018437
ICD10 G83.81
SnomedCT 27982003
English Brown Sequard Disease, Brown Sequard Syndrome, Brown Sequard's Disease, Brown Sequard's Syndrome, Brown-Sequard Disease, Brown-Sequard Syndrome, Brown-Sequard's Disease, Brown-Sequard's Syndrome, Brown-Sequards Disease, Brown-Sequards Syndrome, Syndrome, Brown-Sequard, Syndrome, Brown-Sequard's, BROWN SEQUARD DIS, BROWN SEQUARDS DIS, Brown-Sequard syndrome (diagnosis), Hemispinal Cord Syndrome, Hemispinal Cord Syndromes, Syndrome, Hemispinal Cord, Syndromes, Hemispinal Cord, Hemicord Syndrome, Hemicord Syndromes, Syndrome, Hemicord, Syndromes, Hemicord, Hemiparaplegic Syndrome, Hemiparaplegic Syndromes, Syndrome, Hemiparaplegic, Syndromes, Hemiparaplegic, Brown-Sequard Syndrome [Disease/Finding], browns disease sequard's, brown-sequard disease, brown-sequard syndrome, brown-sequards syndrome, brown-sequard's syndrome, brown sequard syndrome, brown sequards syndrome, Brown-Sequard syndrome, Brown-Séquard syndrome (disorder), Brown-Séquard syndrome
Spanish Síndrome de Brown-Séquard, Síndrome del Cordón Hemiespinal, síndrome de Brown - Séquard (trastorno), síndrome de Brown - Séquard, Síndrome de Brown-Sequard
French Syndrome de l'hémi-moelle, Hémiparaplégie spinale, Syndrome de Brown-Séquard
Japanese ブラウン・セカール症候群, ブラウンセカールショウコウグン, Brown-Sequard症候群, 脊髄性片麻痺, ブラウン-セカール症候群, ブラウンセカール麻痺, 脊髄半側傷害症候群, 脊髄半側切截症候群
Swedish Brown-Sequards syndrom
Czech Brownův-Séquardův syndrom, Brownův-Sequardův syndrom, Brown-Sequardův syndrom, hemisyndrom míšní
Finnish Brown-Séquardin oireyhtymä
Russian BROUN-SEKARA SINDROM, GEMISPINAL'NYI SINDROM, БРОУН-СЕКАРА СИНДРОМ, ГЕМИСПИНАЛЬНЫЙ СИНДРОМ
Italian Emiparaplegia spinale, Emiplegia di Brown Sequard, Emisezione del midollo spinale, Sindrome di Brown-Sequard
Polish Zespół Browna-Sequarda
Hungarian Brown-Sequard-syndroma
Norwegian Brown-Séquards syndrom
Portuguese Síndrome da Monoplegia Espinhal Espástica, Síndrome da Medula Hemiespinhal, Síndrome de Brown-Séquard
German Brown-Sequard Syndrom, Hemiparaplegie, Brown-Séquard-Syndrom, Syndrom der spinalen Halbseitenläsion
Dutch Hemi-ruggenmergsyndroom, Brown-Séquard-syndroom, Syndroom, Brown-Séquard-