Delayed diagnosis of traumatic gunshot wound Brown-Sequard-plus syndrome due to associated brachial plexopathy

Spinal Cord Series and Cases, 2018 · DOI: https://doi.org/10.1038/s41394-018-0075-6 · Published: April 5, 2018

Simple Explanation

This case report discusses a rare instance of Brown-Sequard-Plus Syndrome (BSPS) and Brachial Plexopathy (BP) resulting from a gunshot wound (GSW) to the neck. The patient initially presented with left-sided weakness, and imaging revealed a fracture, but spinal cord imaging was delayed. A delayed diagnosis of BSPS occurred because the symptoms of BP masked the SCI, highlighting the need for thorough examination in trauma cases.

Study Duration

Not specified

Participants

29-year-old male patient

Evidence Level

Case Report

Key Findings

1
The patient had Brown-Sequard-Plus Syndrome (BSPS) at the T2 level along with left lower trunk Brachial Plexopathy (BP) after a gunshot wound.
2
Diagnosis was delayed due to the initial focus on peripheral nerve injury masking the spinal cord injury.
3
Electrodiagnostic studies confirmed the presence of lower trunk brachial plexopathy with evidence of denervation.

Research Summary

This case report describes a rare instance of Brown-Sequard-Plus Syndrome (BSPS) and Brachial Plexopathy (BP) secondary to a gunshot wound. The patient's initial presentation with left hemibody weakness and a fractured T2 transverse process led to a delayed diagnosis of BSPS due to the focus on the more obvious brachial plexopathy. The authors emphasize the importance of thorough neurological examination and high suspicion for combined injuries in trauma patients to ensure early diagnosis and improve functional outcomes.

Practical Implications

Importance of Thorough Examination

Emphasizes the necessity of detailed neurological evaluations in trauma cases, especially when peripheral nerve injuries are present, to avoid missing concurrent spinal cord injuries.

Early Diagnosis Impacts Prognosis

Highlights that early and accurate diagnosis of both BSPS and BP is critical for optimizing patient outcomes and rehabilitation strategies.

Consideration of Combined Injuries

Suggests that clinicians should maintain a high index of suspicion for combined spinal cord and brachial plexus injuries following trauma to the head, neck, or cervical region.

Delayed diagnosis of traumatic gunshot wound Brown-Sequard-plus syndrome due to associated brachial plexopathy

Simple Explanation

Key Findings

Research Summary

Practical Implications

Importance of Thorough Examination

Early Diagnosis Impacts Prognosis

Consideration of Combined Injuries

Study Limitations

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Delayed diagnosis of traumatic gunshot wound Brown-Sequard-plus syndrome due to associated brachial plexopathy

Simple Explanation

Key Findings

Research Summary

Practical Implications

Importance of Thorough Examination

Early Diagnosis Impacts Prognosis

Consideration of Combined Injuries

Study Limitations

Your Feedback

Was this summary helpful?