Cervical disc herniation producing Brown-Sequard syndrome: case report.

Abstract

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. 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. 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.