Spinal cord hemisection syndrome



Brown-Séquard Syndrome refers to spinal cord lesions caused by external compression and lesions inside the spinal cord, leading to motor neuron paralysis on the ipsilateral limb below the lesion plane, deep sensory disappearance, fine tactile dysfunction , vasomotor dysfunction, paralysis of the contralateral limb pain, clinical syndrome of bilateral tactile retention, mainly occurred in the cervical spine. The resulting movement disorder can affect the patient's walking, and the sensory disorder can cause the patient to easily cause damage, especially the skin sensory disorder can cause skin burns and the like, seriously affecting daily life and causing the patient's disability.



In the ascending fiber bundle from the spinal cord to the cerebral cortex, the thin bundle and the wedge bundle conduct the proprioception (deep sensation) and the fine tactile sensation from the ipsilateral side of the body, while the spinal thalamus bundle transmits the contralateral pain sensation, temperature sensation, and rough touch.


an examination

The motor neurons in the ipsilateral limb below the plane of the spinal cord injury disappeared deeply, and the pain in the contralateral limb disappeared and the bilateral tactile sensation remained.


Differential diagnosis

Spinal shock: also known as ridge shock. When the spinal cord is disconnected from the high center, the phenomenon that the spinal cord temporarily loses its ability to reflect and enters an unresponsive state is called spinal shock. The animal whose spinal cord is separated from the high center is called a vertebrate. Intermittent spinal cord breaks are asymptomatic when starting to walk. A certain distance (about 1-5 minutes) appears to be weak on one side or both sides of the lower limbs. Found in spinal arterial endarteritis, spinal cord dysplasia, spinal stenosis.

Transverse spinal cord injury: Spinal dysfunction caused by infection or infection-induced spinal cord dysfunction leading to nerve impulse blockade of all or most of the nerve bundles, limited to several segments of acute transverse spinal cord inflammation. Most are ill after acute infection or vaccination. It is characterized by paralysis of the limbs below the level of spinal cord lesions, loss of sensation and dysfunction of the bladder, rectum and autonomic nerves. It is one of the common spinal diseases. The onset can be seen in any season, but it is more common in late winter and early spring and late autumn and early winter.

Thoracic or lumbar spinal cord injury: a clinical manifestation of spinal cord injury. The number of patients with spinal injuries is increasing, depending on the mechanism of damage, and the classification is also different, so it is also difficult to diagnose. However, in fact, as long as the local pathological anatomical features can be grasped, comprehensive diagnosis and judgment can be made under the premise of comprehensive collection of traumatic history, symptoms and signs, and it is not difficult to obtain a correct diagnosis for most cases. On this basis, the treatment problem is also easy to solve. For some patients with clinical difficulties, CT, MRI, CT plus myelography, CTM and other imaging methods can be used.

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