Cervical stenosis presenting with acute Brown-Séquard syndrome: case report.
METHODS
An unusual case report of cervical stenosis presenting with the Brown-Séquard syndrome. Technical considerations and a literature review are discussed.


OBJECTIVE
To evaluate cervical stenosis as an etiology of the Brown-Séquard syndrome and whether surgical decompression is effective for improving neurologic outcome.


BACKGROUND
Of the causes of the Brown-Séquard syndrome, intrinsic cervical spine pathology has rarely been reported in the literature. We report the first case of a chronic cervical stenosis presenting with an acute Brown-Séquard syndrome after a severe coughing episode.


METHODS
A 75-year-old woman with a previous history of cervical stenosis had sudden onset of weakness develop in the right upper and lower extremities, and disruption of pain and temperature sensation on the left side of her body after an episode of severe coughing associated with pneumonia. Magnetic resonance imaging of the cervical spine revealed severe canal stenosis from C3 through C7, with diffuse intramedullary hyperintensity consistent with myelomalacia of the cervical cord. A decompressive cervical laminectomy with fusion was performed.


RESULTS
The patient improved neurologically, with near complete resolution of the right hemiparesis at 6-month follow-up.


CONCLUSIONS
Multilevel chronic cervical stenosis can present with an acute Brown-Séquard syndrome. Cervical laminectomy and decompression are effective treatments for cervical stenosis with an acute Brown-Séquard syndrome.
Sani
Sepehr
S
Department of Neurosurgery, Rush University Medical Center, Chicago, IL 60612, USA. sepehr_sani@rush.edu
Boco
Tibor
T
Deutsch
Harel
H
D000208:Acute Disease; D000368:Aged; D018437:Brown-Sequard Syndrome / Q000209:etiology* / Q000503:physiopathology; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007796:Laminectomy; D013130:Spinal Stenosis / Q000150:complications* / Q000601:surgery*; D016896:Treatment Outcome