Cervical Disc Herniation Producing Acute Brown-Sequard Syndrome: A Case Report

Abstract

Background: Brown-Sequard Syndrome (BSS) is a kind of rare neurological condition characterized by incomplete spinal cord lesion which results in ipsilateral loss of motor function due to corticospinal tract compression on one side of the body, and contralateral loss of pain and temperature sensitivity as a result of spinothalamic tract dysfunction on the opposite side. The possible causes of Brown-Sequard Syndrome have been frequently observed in patients with spinal traumatic injuries and extramedullary spinal tumors. However, cervical disc herniation is an exceptional cause of this syndrome. Case presentation: A 42-year-old man presented with a one-day history of neck pain and activity limitation of right arm and leg after neck massage. The Computed Tomography (CT) scan of head indicated no abnormal sign. The cervical Magnetic Resonance imaging (MRI) showed a large right-side C4/5 disc herniation which caused rightside compression of spinal cord. The patient received subtotal vertebrectomy of C5 and reconstruction with titanium mesh cage through anterior approach. The muscle strength of patient was improved the contralateral sensory disorder of pain and temperature was alleviated after the surgery. Conclusion: The case demonstrated that a prompt diagnose followed by decompression of cervical spinal cord is essential for the prognosis of the patients who diagnosed as BSS.