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Journal of Clinical Neuroscience 21 (2014) 1229
Contents lists available at ScienceDirect
Journal of Clinical Neuroscience
journal homepage: www.elsevier .com/ locate/ jocn
Images in Neuroscience: Question
An unusual case of Brown-Sequard syndrome
http://dx.doi.org/10.1016/j.jocn.2013.12.0090967-5868/� 2014 Elsevier Ltd. All rights reserved.
DOI of original article: http://dx.doi.org/10.1016/j.jocn.2014.02.001⇑ Corresponding author. Tel.: +61 422 813 601; fax: +61 3 9342 8951.
E-mail address: [email protected] (T. Jurth).
Fig. 1. Sagittal T2-weighted (A), T1-weighted with contrast (B) and T1-weighted without contrast (C) MRI of the thoracic spine. Arrows indicate the lesion and the levaxial images below, being T2-weighted (D), T1-weighted with contrast (E) and T1-weighted without contrast (F).
Timea Jurth ⇑, Andrew Gogos, Andrew H. KayeDepartment of Neurosurgery, Royal Melbourne Hospital, Grattan Street, Parkville, Melbourne, VIC 3050, Australia
1. Clinical background
A 55-year-old woman presented with a right-sided Brown–Sequard syndrome.
She reported a 2 year history of progressive right lower limbweakness and clumsiness and also noted altered temperature sen-sation to her left lower limb whilst showering. There was no leg orback pain and no bladder or bowel dysfunction.
Clinical examination revealed spastic weakness in the rightlower limb with brisk reflexes and bilateral positive Babinski re-sponse. Vibration and proprioception were reduced in the rightleg and sensation to pain and temperature were decreased on
the left side to about the T8 level. An MRI scan of the spine wasperformed (Fig. 1).
2. The most likely diagnosis is:
A. Intradural arachnoid cystB. Spinal cord tumourC. Intervertebral disc herniationD. Idiopathic spinal cord herniationE. Transverse myelitis
Answer on page 1277.
el of the
