Hemorrhage in Brain Stem Cavernoma Presenting with Torticollis

Abstract

Spasmodic torticollis due to an identified focal brain stem lesion is uncommon and abrupt-onset spasmodic torticollis due to midbrain lesions in humans is rarely reported. A 9-year-old female child who had fallen off a bicycle and had lost consciousness for 10 min, vomiting 2–3 times, developed acute torticollis immediately after the injury. Examinations suggested hemorrhage in brain stem cavernoma. A search of the literature written in English revealed that this type of presentation has not been reported previously.

Collum-caput (COL-CAP) concept for conceptual anterocollis, anterocaput, and forward sagittal shift

“…In primary sporadic cases, the family history is negative, whereas in hereditary cases the family history is usually positive [9]. Secondary causes of CACOL include degenerative cervical spine disease, infection [10], immunological disease [11], hypoxia [12], trauma [13], vascular malformation of the central nervous system (CNS) [14], drugs (olanzapine) [15,16], focal or diffuse brain damage, or chemical agents [16]. The preponderance of females in CD (female:male ratio 2:1) suggests that at least in hereditary cases maternal inheritance of mtDNA mutations could play a causative role.…”

Conservative Care of Pediatric Acquired Torticollis: A Report of 2 Cases

“…1,2 Acquired torticollis is also common among adults, but is usually benign in this population, whereas it has a higher likelihood of representing serious underlying pathology in a pediatric population. 3,4 Acquired torticollis has been associated with serious pathologies, including brain and spinal cord tumors, 5,6 hemorrhage, 7 meningitis, 8 and encephalitis. 9 Often the torticollis posture and pain on motion are the only presenting symptoms.…”

“…[4][5][6][7][8][9][10][11][12][13][17][18][19][20][21] The only case series in the literature featuring chiropractic management concerns missed diagnoses of underlying pathologies. 22 One case report of a child with congenital torticollis details how several providers missed diagnosing holocord astrocytoma resulting in quadriplegia.…”