Langelier DM, Schneider KJ, Hurlbert J, Debert CT. The importance of a neck exam in sport-related concussion: Cervical schwannoma in post concussion syndrome.
Phys Ther Sport 2017;
25:84-88. [PMID:
28262355 DOI:
10.1016/j.ptsp.2017.01.003]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 10/07/2016] [Accepted: 01/13/2017] [Indexed: 11/30/2022]
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.
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