TY - JOUR
T1 - The importance of a neck exam in sport-related concussion
T2 - Cervical schwannoma in post concussion syndrome
AU - Langelier, David M.
AU - Schneider, Kathryn J.
AU - Hurlbert, John
AU - Debert, Chantel T.
N1 - Publisher Copyright:
© 2017 Elsevier Ltd
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - 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.
AB - 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.
KW - Mild traumatic brain injury
KW - Neck pain
KW - Post concussion syndrome
KW - Schwannoma
KW - Sport-related concussion
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U2 - 10.1016/j.ptsp.2017.01.003
DO - 10.1016/j.ptsp.2017.01.003
M3 - Article
C2 - 28262355
AN - SCOPUS:85014077749
VL - 25
SP - 84
EP - 88
JO - Physical Therapy in Sport
JF - Physical Therapy in Sport
SN - 1873-1600
ER -