1996 Volume 5 Issue 1 Pages 59-63
A case of cervical cord injury in a 34-year-old man that was caused by a stab wound is reported. He was involved in a fight and on admission to hospital he was unable to move. Gross inspection revealed two Stab wounds in the anterior and the posterior neck ; the latter wound was associated with cerebrospinal fluid (CSF) leakage. A neurological examination performed on admission revealed almost complete right hemiparesis, right hemihypesthesia and left hemihypalgesia, signs of a cervical hemispinal cord injury indicative of Brown-Sequard's syndrome. MRIs taken on admission disclosed the routes of the two stab wounds and a spinal cord injury associated with a small epidural collection of bloody CSF or a hematoma. After conservative treatment for several days, the patient's CSF retension gradually increased and CSF leakage was detected. Further, the patient complained of a radiating pain in the body trunk and both legs that was found to be caused by cystic compression. Thus, the patient underwent surgery 23 days after sustaining his injuries, and a dural defect and an incomplete hemitransection of cervical cord was found between C4 and C5 lamina. On accomplishing a laminectomy of the C4 to C5 region, the dural defect was closed with lyodura and the wall of the cyst was carefully removed. The patient's postoperative neurological signs greatly improved and he made good progress in rehabilitation. After being able to walk by himself, he returned to his occupation with no serious deficits. This is a rare case of a stab wound spinal cord injury, probably inflicted by a knife, that resulted in an excellent recovery from Brown-Sequard's syndrome.
