Resumen de Trauma vértebro medular por arma blanca y síndrome de Brown Sequard: a propósito de un caso

Carlos Arturo Casallo Quiliano

• español

  Introducción: El Síndrome de Brown Sequard a consecuencia de la lesión de la hemimédula espinal producida por arma blanca es poco frecuente. Reportamos un caso de este síndrome en su forma clásica.

  Caso Clínico: Paciente varón de 18 años, sufre trauma penetrante con arma blanca en región cervical derecha, presentando hemiparesia ipsilateral, trastorno de propiocepción ipsilateral y termoalgésica contralateral. Los estudios mostraron una fractura laminar C6 derecha y edema medular en dicho nivel. Fue sometido a hemilaminectomia C6.

  Al tercer mes postoperatorio mejora el déficit neurológico.

  Conclusiones: El síndrome de Brown Sequard en su forma clásica o "pura" y producida por arma blanca es raro. El estudio mandatorio en este síndrome es la . El tratamiento quirúrgico debe ser inmediato solo si hay evidencia de fragmento óseo, metálico o hematoma en el canal medular.

• English

  Introduction: It is unusual to observe the occurrence of Brown Séquard syndrome as a consequence of a lateral hemisection of the spinal cord caused by a stab wound. We report a case of this syndrome showing its typical presentation.

  Clinical Case: A male, 18-year old subject was attacked and suffered a stab wound in his right cervical area. The patient developed ipsilateral hemiparesis, an ipsilateral proprioception disturbance and a contralateral thermo-algesic disturbance. Image studies showed a laminar fracture in C6 and spinal edema in the same area. The patient underwent a C6-laminectomy. Three months after surgery, his neurological condition improved.

  Conclusions: It is unusual to observe the occurrence of Brown Séquard syndrome in its so-called classical or 'pure' form caused by a stab wound. The mandatory image study to perform in these cases is magnetic resonance imaging. Surgical therapy should be immediately performed only if there is evidence of a bone or metal fragment in the spinal canal, or if there is a hematoma in this area.