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Zhou LL, Zhu SG, Fang Y, Huang SS, Huang JF, Hu ZD, Chen JY, Zhang X, Wang JY. Neck pain and absence of cranial nerve symptom are clues of cervical myelopathy mimicking stroke: Two case reports. World J Clin Cases 2022; 10:11835-11844. [PMID: 36405285 PMCID: PMC9669878 DOI: 10.12998/wjcc.v10.i32.11835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/27/2022] [Accepted: 08/25/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cervical myelopathy is a potential stroke imitator, for which intravenous thrombolysis would be catastrophic.
CASE SUMMARY We herein present two cases of cervical myelopathy. The first patient presented with acute onset of right hemiparesis and urinary incontinence, and the second patient presented with sudden-onset right leg monoplegia. The initial diagnoses for both of them were ischemic stroke. However, both of them lacked cranial nerve symptom and suffered neck pain at the beginning of onset. Their cervical spinal cord lesions were finally confirmed by cervical computed tomography. A literature review showed that neck pain and absence of cranial nerve symptom are clues of cervical myelopathy.
CONCLUSION The current report and the review remind us to pay more attention to these two clues in suspected stroke patients, especially those within the thrombolytic time window.
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Affiliation(s)
- Li-Li Zhou
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Shi-Guo Zhu
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Yuan Fang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Shi-Shi Huang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jie-Fan Huang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Ze-Di Hu
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jin-Yu Chen
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Xiong Zhang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jian-Yong Wang
- Institute of Geriatric Neurology, Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
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Brown-Sequard syndrome after manual manipulation of the cervical spine: case report. Spinal Cord Ser Cases 2022; 8:32. [PMID: 35292623 PMCID: PMC8924239 DOI: 10.1038/s41394-022-00501-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Spinal cord injury after manual manipulation of the cervical spine is rare and has never been described resulting from a patient performing a manual manipulation on their own cervical spine. To the best of our knowledge, this is the first well-documented case of this association. CASE PRESENTATION A healthy 29-year-old man developed Brown-Sequard syndrome immediately after performing a manipulation on his own cervical spine. Imaging showed large disc herniations at the levels of C4-C5 and C5-C6 with severe cord compression, so the patient underwent emergent surgical decompression. He was discharged to an acute rehabilitation hospital, where he made a full functional recovery by postoperative day 8. CONCLUSION This case highlights the benefit of swift surgical intervention followed by intensive inpatient rehab. It also serves as a warning for those who perform self-cervical manipulation.
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