A patient with a gunshot wound to the torso presents with ipsilateral weakness and contralateral loss of sensation. Which spinal cord injury is most consistent with this pattern?

• A. Anterior Cord Syndrome
• B. Brown-Sequard Syndrome
• C. Central Cord Syndrome
• D. Posterior Cord Syndrome

Answer: (B)

This pattern comes from a spinal cord hemisection caused by penetrating trauma, known as Brown-Sequard syndrome. When one side of the cord is damaged, the motor pathways on that same side (the corticospinal tract) lead to weakness or paralysis below the injury. The same side’s dorsal columns are also affected, so vibration and proprioception are lost on that side below the lesion. Because the spinothalamic tract crosses to the opposite side soon after entry, pain and temperature sensation are lost on the opposite side below the injury. So you get ipsilateral weakness with ipsilateral loss of proprioception, plus contralateral loss of pain and temperature—exactly the pattern described.

Other cord syndromes produce different mixes of deficits. Anterior Cord Syndrome typically shows motor and pain/temperature loss below the lesion with preserved vibration and proprioception. Central Cord Syndrome often causes greater weakness in the upper extremities with variable sensory loss, rather than a clear ipsilateral motor and contralateral sensory pattern. Posterior Cord Syndrome mainly impairs vibration and proprioception with relatively preserved motor function and pain/temperature sensation.