Neurología : publicación oficial de la Sociedad Española de Neurología
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Review Case Reports
[Transient Brown-Séquard syndrome due to spontaneous spinal epidural hematoma].
Spinal epidural hematoma (SEH) is a low incidence injury. When the cause of bleeding is unknown, which occurs in 50% of the cases, we refer to it as spontaneous SEH. The clinical presentation is characterized by acute radicular pain followed by cord compression syndrome. ⋯ After 72 h, the patient was completely recovered. We have reviewed the 14 cases of spinal epidural hematoma and Brown- Séquard syndrome previously reported, only 2 of them were resolved by conservative management. We conclude that when SEH presents as Brown-Séquard syndrome it usually has a more benign course and that in some cases a conservative management can be considered.
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Case Reports
[Postoperative bilateral brachial plexopathy mimicking the "man-in-the-barrel" syndrome].
We describe a patient with a postoperative bilateral upper limb palsy due to involvement of the upper trunk of the brachial plexus. The weakness distribution (bilateral upper limb paresis without leg involvement) reminded of the classic "man-in-the-barrel" syndrome, which is usually due to bilateral watershed infarcts of the brain in relation with severe hypotension. Bilateral postoperative brachial plexopathies are very uncommon and should be distinguished from the "man-in-the-barrel" syndrome of "central" origin, since the former bears a much better prognosis and management is different. The mechanisms of plexus damage during surgery, as well as the different etiologies of the "man-in-the-barrel" syndrome, are discussed.