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Neurological Rehabilitation

A Blunt Cause of Brown-Sequard Syndrome: A Case Report

Thursday, October 23, 2025
5:00 PM - 6:30 PM MT
Location: Open Kiosks

    Poster Presenter(s)

  • Alexandria R. Ochs, DO,MPH (she/her/hers)

    Resident Physician
    ECU Health (Vidant Medical Center/East Carolina University) PM&R Program
    Winterville, North Carolina

    • Co-Author(s)

  • RM

    Raymund Millan, MD

    SCI Director , Attending Physician
    Vidant Medical Center/East Carolina University PM&R Program
    Greenville, North Carolina

Disclosure(s):
Alexandria R. Ochs, DO,MPH: No financial relationships to disclose
Raymund Millan, MD: No financial relationships to disclose
Case Diagnosis: 49-year-old male with Brown-Sequard Syndrome after motorcycle collision

Case Description or Program Description: A 49-year-old male was admitted after a motorcycle collision. He sustained multiple injuries including facial fractures, bilateral C6 facet fractures, C7 superior articular facet fracture, C6-C7 widening, and left pneumothorax. Magnetic resonance imaging (MRI) spine showed intramedullary traumatic hematoma at C4-5 with expansile cord. He was ultimately admitted to inpatient rehabilitation, where he was diagnosed with Brown-Sequard Syndrome.

Setting: Academic Inpatient Rehabilitation and Acute Care Hospital

Assessment/Results: Upon rehabilitation admission, ASIA examination showed 4-5/5 strength in all left-sided myotomes and diminished strength distal to C6 on the right. He had absent pinprick sensation in all left dermatomes distal to C5 and diminished light touch from C6 to T4. Pinprick sensation was intact in all right dermatomes except C6 to C8, light touch was intact throughout except C6. Voluntary anal contraction and deep anal pressure were preserved, resulting in C5 ASIA D incomplete injury consistent with Brown-Sequard Syndrome. Through intensive rehabilitation, he progressed from total assist for bed mobility to ambulating 432 feet using large-base quad cane with contact guard assist.

Discussion (relevance): Brown-Sequard Syndrome is a rare neurological condition characterized by spinal cord lesion resulting in weakness or paralysis on one side of the body and contralateral loss of sensation. It occurs most commonly in the cervical or thoracic region and affects 1-4% of spinal cord injuries. It is most commonly associated with traumatic injuries, with knife injuries being the most common. There are also a variety of non-traumatic, vascular, and infectious etiologies.

Conclusions: Accurate identification of etiology of neurological deficits is important to prevent associated complications including hypotension, spinal shock, pulmonary embolism, and infections. In this case, the etiology of Brown-Sequard Syndrome was blunt trauma in combination with a vascular component. Although less common, these etiologies of Brown-Sequard Syndrome are vital to keep in mind.