TRAUMATIC PARTIAL HEMISECTION OF THE SPINAL CORD

Abstract

Incomplete hemilateral injuries of the spinal cord in the cervical region, with the resulting sensory and motor manifestations, are uncommon, and most often are the result of indirect violence—fracture dislocation of the vertebrae. In the World War, shrapnel and sharp, irregular shell fragments sometimes caused traumatic partial hemisection of the spinal cord by direct violence. Both of these, however, rarely cause strictly unilateral lesions. Stab wounds of the spinal cord are rare and give the most circumscribed and discrete lesions, and hence the most limited and definite sensory dissociation along with localized motor manifestations. The symptom-complex of partial hemisection differs from the Brown-Sequard syndrome of complete hemisection in that in the former the contralateral sensory loss is limited to pain and temperature senses, and there are no signs of disturbance of posterior column sensation. Hyperpathic sensation (heightened feeling tone), so well described by Foerster, 1 in which there is loss