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 Citation (Scopus)

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

Fingerprint

Post-Concussion Syndrome
Brain Concussion
Neck Pain
Neurilemmoma
Sports
Neck
Photophobia
Spinal Nerves
Alberta
Sports Medicine
Palpation
Wounds and Injuries
Neurologic Examination
Dizziness
Articular Range of Motion
Craniocerebral Trauma
Athletes
Physical Examination
Canada
Accidents

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

Cite this

The importance of a neck exam in sport-related concussion : Cervical schwannoma in post concussion syndrome. / Langelier, David M.; Schneider, Kathryn J.; Hurlbert, John; Debert, Chantel T.

In: Physical Therapy in Sport, Vol. 25, 01.05.2017, p. 84-88.

Research output: Contribution to journalArticle

Langelier, David M. ; Schneider, Kathryn J. ; Hurlbert, John ; Debert, Chantel T. / The importance of a neck exam in sport-related concussion : Cervical schwannoma in post concussion syndrome. In: Physical Therapy in Sport. 2017 ; Vol. 25. pp. 84-88.
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