An automobile accident person suffering from a back injury is brought to the hospital. On examination it was found that he has paralysis of left lower limb and right lower limb is not paralyzed.
Q1. What kind of injury do you think he has
sustained?
Q2. What other features you are likely to get?
A1. Brown squared syndrome or Hemiplegia or Hemi section of spinal cord
A2.
Below the level of injury
Same side
- Sensory changes: Pain fine touch & temperature and crude touch retained Loss of tactile localization, discrimination.
- Motor changes: Extensive paralysis, increased muscle tone, rigidity, superficial reflexes are lost, Babinski sign positive, deep reflexes are exaggerated.
Opposite side
- Sensory changes: Crude touch, pain & temperature are lost. Fine touch , tactile localization, tactile discrimination carried by dorsal column are retained
- Motor changes: Mild or no paralysis
At the level of injury
Same side
- Sensory changes: Complete anesthesia
- Motor changes: Loss of muscle tone (damage to anrerior horn cell). Loss of all reflexes
On the opposite side
- Sensory changes-: Pain, temperature. Crude touché are lost. Fine touch, tactile localization, discrimination are retained
- Motor changes: Mild paralysis
Above the level of injury
- band of hyperesthesia irritation of the cut end of the damaged fibers