Cervical disc herniation producing Brown-Sequard syndrome: case report.
BACKGROUND
Brown-Sequard syndrome is an incomplete spinal cord lesion characterized by a clinical picture reflecting hemisection of the spinal cord in the cervical or thoracic region. Brown-Sequard syndrome may be the result of penetrating injury to the spine, but many other etiologies have been described. In particular, cervical disc herniation has been rarely reported as a cause of this syndrome, and including the first article of Stookey in 1928, 9 only 22 cases have been reported.


METHODS
The case of a man with a large left paramedian C5-C6 disc herniation, with ipsilateral spinal cord compression, is reported. An area of left-sided spinal cord hyperintensity was also present on MRI, an expression of left hemicord damage. Microdiscectomy and anterior cervical fusion with carbon fiber cage containing a core of granulated coralline hydroxylapatite was performed. A complete motor deficit recovery and a marked sensitive deficit improvement was obtained.


CONCLUSIONS
A critical review of the pertinent literature is proposed, and the neuroradiologic, therapeutic, and prognostic implications are discussed. Brown-Sequard syndrome produced by a cervical disc herniation is presumably often underdiagnosed, and early surgical intervention is always recommended.
Mastronardi
Luciano
L
Department of Neurological Sciences, Division of Neurosurgery, Sandro Pertini Hospital, Rome, Italy. mastro@tin.it
Ruggeri
Andrea
A
D000328:Adult; D018437:Brown-Sequard Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D002574:Cervical Vertebrae / Q000601:surgery; D017586:Diskectomy; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D009333:Neck; D019547:Neck Pain / Q000209:etiology; D012678:Sensation Disorders / Q000209:etiology; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology; D013123:Spinal Fusion; D016896:Treatment Outcome