Neurological Surgery No Shinkei Geka Volume 29, Issue 7 (July 2001)

Brown-Séquard Syndrome and Cervical CSF Leakage due to a Knife Injury : A Case Report Kenji SUZUYAMA 1 , Toru KOIZUMI 1 , Hiroki UDONO 1 , Toshihiro MINETA 1 , Makoto ICHINOSE 1 , Masamitsu ABE 1 , Kazuo TABUCHI 1 1Department of Neurosurgery, Saga Medical School Keyword: Brown-Séquard syndrome , spinal injury , CSF leakage pp.647-651
Published Date 2001/7/10
  • Abstract
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We report a case of Brown-Séquard syndrome and cervical CSF leakage caused by a knife injury, A 34-year-old man was involved in a fight and was stabbed on his occiput and back with a knife. Neurologicalexamination on admission showed right hemiparesis, right hemihypesthesia and left hemihypalgesia, in-dicating Brown-Séquard syndrome. Furthermore, cerebrospinal fluid was leaking from the occipital stabwound. Head CT scan showed massive accumulation air in the subarachnoid space. Cervical MRI showedthat the injury tract reached to the space between the occipital bone and the atlas. One week after admis-sion, suboccipital craniectomy and duraplasty were performed because of continuous CSF leakage.Although, the CSF leakage recurred due to the wound infection, it disappeared naturally as the patient'sgeneral condition improved. Follow-up MRI studies demonstrated the cervical spinar lesion as hyperintensi-ty on T2WI, which localized at the right side of the spinal cord. The patient's hemiparesis gradually im-proved and he underwent rehabilitation.

Spinal cord injury due to a stab wound by a knife is rare in Japan. In this case, we suppose that themechanism of spinal cord injury was due to direct injury by a knife avoiding the lateral corticospinal tractbecause his right hemiparesis obviously improved.

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Neurological Surgery 脳神経外科
29巻7号 (2001年7月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院