Reflections on the intensive care of 106 acute cervical spinal cord injury patients in the resuscitation unit of a general traumatology centre

[Brown-Séquard syndrome after closed injury of the cervical spine]

The case of a Brown-Séquard syndrome at the C5 level, in a 21-year-old young man after a traffic accident is reported. Initially, the symptoms of spinal injury were concealed by those related to head and face trauma. The neurologic assessment showed a hemiplegia located in the same side as the medullar injury with a controlateral thermo-algesic anaesthesia. X-rays, CT-scan and MRI of the cervical spine confirmed the diagnosis. The treatment included the immobilization of the spine combined with i.v. methylprednisolone (bolus of 30 mg.kg-1 followed by a continuous infusion at a rate of 5 mg.kg-1.h-1 for 23 hours). The outcome was favourable. Six weeks later, the patient was again able to walk. However the thermo-algesic anaesthesia remained unchanged. This case report underlines the necessity of a careful and complete neurologic assessment of trauma patients and reminds of the possibility of occurrence of a Brown-Séquard syndrome in them.