The association between cervical lordosis and age, sex, history of cervical trauma and sedentarity: A CT study

Internal carotid artery (ICA) dissection is a cause of stroke, but it is often underdiagnosed in children. ICAs’ risk factors and pathogenic mechanisms are poorly understood, and the treatment is still empirical. We report the case of a previously healthy 9-year-old girl who presented with involuntary hypertonic closure of the right hand associated with transient difficulty for both fine movements of the right arm and speech. She had a history of minor cervical trauma occurring 20 days prior to our observation without other associated risk factors. Magnetic resonance imaging and magnetic resonance angiography showed ischemic lesions due to the left ICA dissection. Treatment with both acetylsalicylic acid and levetiracetam allowed recanalization of the ICA associated with the resolution of clinical signs. Our clinical case suggests that the ICA dissection must be suspected early whenever a child manifests mild neurologic deficits after a cervical trauma, especially if they are associated with headache and/or cervical pain. Moreover, the management of ICA dissection must be improved.

Download Full-text

Aneurysmal bone cyst of the spine

The Journal of Laryngology & Otology ◽

10.1258/0022215054273052 ◽

2005 ◽

Vol 119 (6) ◽

pp. 495-497 ◽

Cited By ~ 5

Author(s):

C E B Giddings ◽

D Bray ◽

S Stapleton ◽

H Daya

Keyword(s):

Differential Diagnosis ◽

Aneurysmal Bone Cyst ◽

Osteolytic Lesion ◽

Bone Cyst ◽

Treatment Modalities ◽

Open Resection ◽

Cervical Trauma ◽

Radiographic Appearance ◽

Posterior Triangle ◽

History Of

The authors present the case of an 11-year-old boy with a painful, rapidly expanding lesion in the posterior triangle of the neck. There was no history of cervical trauma. Computerized tomography of the neck revealed a unicameral (single-chambered) aneurysmal bone cyst involving the C3 vertebra. Treatment was by open resection and curettage; no recurrence was seen at six months. We discuss the natural history, differential diagnosis, radiographic appearance and treatment modalities for this unusual, benign, expanding, osteolytic lesion containing blood-filled cystic cavities.

Download Full-text

Mode of onset of dropped head syndrome and efficacy of conservative treatment

Journal of Orthopaedic Surgery ◽

10.1177/2309499020938882 ◽

2020 ◽

Vol 28 (2) ◽

pp. 230949902093888

Author(s):

Takuya Kusakabe ◽

Kenji Endo ◽

Yasunobu Sawaji ◽

Hidekazu Suzuki ◽

Hirosuke Nishimura ◽

...

Keyword(s):

Conservative Treatment ◽

Recovery Rate ◽

Vertical Axis ◽

Acute Onset ◽

Sacral Slope ◽

Cervical Trauma ◽

Sagittal Vertical Axis ◽

Dropped Head Syndrome ◽

History Of ◽

Onset Group

Purpose: The initial treatment of dropped head syndrome (DHS) is basically nonsurgical, but the mode of onset of DHS and efficacy of conservative treatment have not been fully clarified. Methods: The subjects were 38 DHS patients without neuromuscular disease (11 men and 27 women, average age 74.5 years). Cervical collar, physical therapy, and temporary medication for cervical pain were provided for all DHS patients. The following parameters were measured on lateral global spine standing radiographs: sagittal vertical axis (SVA), cervical sagittal vertical axis, C2–C7 angle, first thoracic slope, thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt, and pelvic incidence. According to the mode of onset of DHS, the subjects were classified into acute-onset group (<3 months) and chronic-onset group (≥3 months). Results: Acute- and chronic-onset DHS were observed in 20 and 18 patients, respectively. A history of cervical trauma was involved in nine and two cases of acute- and chronic-onset DHS, respectively. Acute-onset DHS included more balanced-SVA (B-SVA: −30 mm <SVA ≤40 mm) than chronic-onset DHS. In conservative cases, the recovery rate was better in acute-onset DHS with B-SVA. In acute-onset DHS treated conservatively, the recovery rate was significantly poor in cervical trauma cases. Conclusions: Acute-onset DHS includes more balanced SVA and a history of cervical trauma, while acute-onset DHS without a history of cervical trauma has better prognosis by conservative treatment. Surgical indications for DHS should be carefully determined, and sufficient conservative treatment is essential.

Download Full-text