Ver el código de «Brown-Séquard syndrome»

==Background==
[[File:Dermatoms alt.png|thumb|Sensory dermatome by spinal level.]]
[[File:Spinal cord tracts.svg|thumb|Spinal cord tracts]]
[[File:Brown Sequard.png|thumb|Anatomy of Brown-Sequard injury.]]
*Hemisection (or unilateral compression) of the spinal cord
*Pure Brown-Séquard is rare; most cases are ''Brown-Séquard plus'' syndrome with incomplete hemisection
*Most common cause: penetrating trauma (stab wounds > gunshot wounds)
*Other causes: [[spinal cord compression (non-traumatic)|tumor]], [[epidural abscess]], [[epidural hematoma]], [[multiple sclerosis]], [[spinal cord infarction]]

==Clinical Features==
*Classic pattern results from the anatomy of spinal tract decussation:
**'''Ipsilateral''' motor deficits: spastic paresis/[[weakness|paralysis]] (corticospinal tract — decussates at medulla)
**'''Ipsilateral''' loss of proprioception, vibration, and light touch (dorsal columns — decussate at medulla)
**'''Contralateral''' loss of pain and temperature (spinothalamic tract — decussates 1-2 levels above entry in anterior white commissure)
*Ipsilateral [[Horner syndrome]] if cervical cord involvement
*At the level of the lesion: ipsilateral LMN signs, band of ipsilateral anesthesia

==Differential Diagnosis==
{{Spinal cord syndromes DDX}}

==Evaluation==
*MRI spine — imaging modality of choice to identify the lesion
*CT spine if MRI not immediately available or if penetrating trauma
*Neurological level assessment: motor, sensory (pinprick and light touch), rectal tone

==Management==
{{Acute spinal cord injury treatment}}
*Address underlying etiology (surgical decompression for compressive lesions, antibiotics for abscess)

==Prognosis==
*Best prognosis of all incomplete spinal cord syndromes
*>90% of patients regain ambulatory function
*Motor recovery typically begins within 1-6 months

==Disposition==
*Admit all patients — neurosurgery or spine surgery consult
*ICU admission for high cervical lesions or hemodynamic instability

==See Also==
*[[Spinal cord syndromes]]
*[[Anterior cord syndrome]]
*[[Central cord syndrome]]
*[[Spinal cord compression (non-traumatic)]]

==References==
<references/>

[[Category:Neurology]]
[[Category:Trauma]]