Neurogenic Atrophy of Suboccipital Muscles After a Cervical Injury

Abstract

This case report describes abnormalities in bilateral rectus capitis posterior minor muscles in one individual with persistent head and neck pain. These findings are muscle atrophy, fatty infiltration on magnetic resonance imaging, and electromyographic abnormalities compatible with denervated muscle. The objective of the study contained herein was to determine if fatty infiltration on magnetic resonance imaging of the rectus capitis posterior minor muscle is the result of disuse or denervation. Electromyography and magnetic resonance imaging data were collected from normal and atrophied muscles. Electromyography and magnetic resonance imaging abnormalities compatible with denervation atrophy were detected. Although we cannot rule out aging or other unknown causes, we suspect that denervation is caused by nerve damage from trauma to the C1 dorsal ramus as a consequence of entrapment within the rectus capitis posterior major muscle.

Rehabilitative Ultrasound Imaging of the Abdominal Muscles

“…The mean CSA of the trunk at rest was 393.90 6 8.07 cm 2 , which decreased to 362.61 6 8.85 cm during the ADIM. 2,39 There was a corresponding significant increase in thickness of the TrA and OI muscles during the ADIM, as measured by both MRI and USI. The activation was symmetrical between sides.…”

“…2,11,12,109 Although magnetic resonance imaging (MRI) is considered the gold standard for detecting these changes, researchers have suggested that USI may also provide some insight, as these tissue changes result in a degeneration of a muscle's architectural features and an increase in their echogenicity. 55,100 In a prospective study, Strobel et al 100 developed a qualitative evaluation tool ( TaBle 1) to evaluate the accuracy of USI in depicting fatty atrophy of the supraspinatus and infraspinatus muscles, using MRI as the reference criterion.…”

Occipital Bone Fossa Associated with the Position of Rectus Capitis Posterior Minor Muscle

“…Clinically, alterations of the suboccipital muscles can lead to compression of neural elements (Andary et al, 1998) and the role that RCPm muscle plays a role in head posture at cervical level and could be linked to cervicogenic headache, in some cases associated with muscle attachments to the dura mater (Nayak et al;Hallgren et al, 2014b;Farmer et al, 2015). …”

The clinical presentation of chronic whiplash and the relationship to findings of MRI fatty infiltrates in the cervical extensor musculature: a preliminary investigation

“…However, on the contrary, higher muscle fat indices in the subjects with chronic WAD were present in the suboccipital muscles and the deep segmental multifidii, which may point to more specific pathophysiological processes. Two other studies have provided preliminary evidence of an association between sub-occipital muscle degeneration and persistent pain [1] and balance disturbance [37]. A higher incidence of dizziness and unsteadiness has been reported by patients with chronic WAD, suggesting that such disturbances were the result of altered somatosensory input [61].…”