This protocol addresses management of Brown-Séquard syndrome in adult patients aged 14 and older who sustain an acute spinal cord injury and present more than 8 hours after the time of injury. The delayed presentation window defines the specific clinical scenario and directly determines which interventions are and are not indicated.
The guideline applies across both the acute and rehabilitation phases of acute spinal cord injury in adult patients (14 years or older) with postresuscitation ASIA grades A through D. The distinguishing feature here is the timing: the patient did not present within the first 8 hours of injury — placing them in a distinct management pathway.
The approach for this scenario involves both a surgical intervention within a defined early window and a pharmacological thromboprophylaxis strategy. Importantly, a high-dose pharmacological infusion that is sometimes considered in acute spinal cord injury is specifically not recommended for patients in this after-8-hour presentation group. The full eligibility criteria, sequencing, and complete regimen are detailed in the structured protocol.
DOI: 10.1177/2192568217703387