Brown-Séquard syndrome
Description
- Hemisection (or hemi-injury) of the spinal cord -> a dissociated syndrome that reflects where each tract decussates
- *Pure Brown-Sequard is rare. Brown-Sequard PLUS is common* - most lesions are incomplete and asymmetric rather than a clean hemisection
The anatomy that generates the signs
| Tract | Decussates | Consequence |
|---|---|---|
| Corticospinal | In the medulla (above the cord) | Ipsilateral weakness below the lesion |
| Dorsal columns | In the medulla (above the cord) | Ipsilateral loss of vibration and proprioception |
| Spinothalamic | In the cord, within 1-2 segments of entry | CONTRALATERAL loss of pain and temperature, beginning 1-2 levels BELOW the lesion |
- *The one tract that crosses in the cord is the one that produces contralateral signs. Everything else stays on the same side*
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