The importance of a neck exam in sport-related concussion: Cervical schwannoma in post concussion syndrome

David M. Langelier, Kathryn J. Schneider, John Hurlbert, Chantel T. Debert

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Objective Few cases of cervical schwannoma have been reported following head trauma. The present case, involves a schwannoma of the C2 spinal nerve mimicking post-concussion symptoms following a sport-related concussion (SRC). Design Case study. Setting University of Calgary, Sport Medicine Clinic, Calgary, Alberta, Canada. Results We report a 28 year old, athlete who developed headache, dizziness, photophobia, and neck pain following a cycling accident. She presented nine months later to our sports clinic with persistent symptoms. She had a normal neurological examination but complained of painful neck range of motion, and exacerbation of symptoms with neck extension. On palpation, a lump was found in the right suboccipital muscles and MRI showed a T2 hyperintense mass at the C1-2 level. The patient underwent resection and histology revealed a schwannoma of the C2 nerve root. Following resection her symptoms improved, with no recurrence at 2 months follow up. Conclusion Our patient's slow recovery following SRC is consistent with a schwannoma formation, which may have been precipitated by the injury itself or merely unmasked from trauma. This case illustrates the importance of a thorough physical examination and broad differential in patients presenting with worsening of symptoms after initial improvement in SRC.

Original languageEnglish (US)
Pages (from-to)84-88
Number of pages5
JournalPhysical Therapy in Sport
Volume25
DOIs
StatePublished - May 1 2017
Externally publishedYes

Keywords

  • Mild traumatic brain injury
  • Neck pain
  • Post concussion syndrome
  • Schwannoma
  • Sport-related concussion

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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