Trauma and burns: Brown-Sequard syndrome: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Trauma and burns: Brown-Sequard syndrome

Sample item

A man is stabbed on the right side of the back at the T10 level. He has weakness and loss of joint position sense in the right leg and loss of pain and temperature sensation in the left leg. What is the explanation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Right hemisection of the cord: crossed spinothalamic fibres are lost on the left and uncrossed motor and dorsal column fibres on the right

In Brown-Sequard syndrome, one half of the cord is damaged. Corticospinal and dorsal column fibres are uncrossed at this level, so ipsilateral motor and proprioceptive loss results, while spinothalamic fibres cross within a segment or two of entry, giving contralateral pain and temperature loss.

Option by option

  • A. Anterior spinal artery infarction

    Anterior spinal artery infarction causes bilateral motor and pain-temperature loss with preserved dorsal columns.

  • B. Injury to the right cauda equina roots

    Cauda equina injury occurs below L1 and causes lower motor neuron signs.

  • C. Complete transection of the cord at T10

    Complete transection abolishes all function bilaterally below the level.

  • D. Right hemisection of the cord: crossed spinothalamic fibres are lost on the left and uncrossed motor and dorsal column fibres on the right (correct)

    Correct. A hemisection causes ipsilateral motor and dorsal column loss with contralateral pain and temperature loss.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Right hemisection of the cord: crossed spinothalamic fibres are lost on the left and uncrossed motor and dorsal column fibres on the right. In Brown-Sequard syndrome, one half of the cord is damaged.

Why is "Anterior spinal artery infarction" not the answer?

Anterior spinal artery infarction causes bilateral motor and pain-temperature loss with preserved dorsal columns.

Why is "Injury to the right cauda equina roots" not the answer?

Cauda equina injury occurs below L1 and causes lower motor neuron signs.

Why is "Complete transection of the cord at T10" not the answer?

Complete transection abolishes all function bilaterally below the level.

What concept does this question test?

It tests Trauma and burns: Brown-Sequard syndrome in General Surgery. Corticospinal and dorsal column fibres are uncrossed at this level, so ipsilateral motor and proprioceptive loss results, while spinothalamic fibres cross within a segment or two of entry, giving contralateral pain and temperature loss.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma and burns: Brown-Sequard syndrome?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.