Brown-Sèquard syndrome caused by type III odontoid fracture: a case report and review of the literature.
METHODS
Case report.


OBJECTIVE
To present the second case of Brown-Sèquard syndrome (BSS) produced by type III odontoid fracture managed by conservative treatment.


BACKGROUND
The occurrence of BSS due to odontoid fracture is scarce. So far 6 cases have been reported, and only 1 is produced by type III odontoid fracture. The possible pathophysiology, clinical course and treatment outcome have been rarely discussed.


METHODS
A 39-year-old man presented with weakness of his left arm and leg, mild neck pain, and impaired proprioceptive and light touch sensations below the left C2 dermatome. There were decreased pain and temperature sensations below the right C4 dermatome too. Computerized tomography showed odontoid type III fracture with posterior displacement at that level. Magnetic resonance imaging presented focal hyperintensity around the C2 vertebral level. High dose of prednisolone, close reduction with Gardner-Wells tong skull traction, following external stabilization by Halo-Vest and rehabilitation therapy were applied.


RESULTS
Complete resolution of neck pain and significant improvement of motor and sensory functions, i.e., light touch and proprioception, were shown 2 months after spinal injury. Impaired temperature discrimination persisted, however.


CONCLUSIONS
BSS is rarely caused by type III odontoid fracture and this is the second report. Conservative intervention is advantageous for both type III odontoid fracture and BSS which is consistent with previous results.
Wu
Yung-Tsan
YT
Department of Physical Medicine and Rehabilitation, National Defense Medical Center, Taipei, Taiwan.
Ho
Cheng-Wen
CW
Chang
Shin-Tsu
ST
Chen
Liang-Cheng
LC
D000203:Activities of Daily Living; D000328:Adult; D018437:Brown-Sequard Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009809:Odontoid Process / Q000000981:diagnostic imaging / Q000293:injuries*; D011859:Radiography; D016103:Spinal Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000534:rehabilitation; D014143:Traction; D016896:Treatment Outcome
D008775:Methylprednisolone