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Malignant Nerve Sheath Tumor of the Spinal Accessory Nerve: A Unique Presentation of a Rare Tumor
Omair A. Sheikh,Ann Reaves,Francis A. Kralick,Ari Brooks,Rachel E. Musial,James Gasperino 대한신경과학회 2012 Journal of Clinical Neurology Vol.8 No.1
Background Malignant peripheral nerve sheath tumors (MPNSTs), sarcomas originating from tissues of mesenchymal origin, are rare in patients without a history of neurofibromatosis. Case Report We report a case of an MPNST of the spinal accessory nerve, unassociated with neurofibromatosis, which metastasized to the brain. The tumor, originating in the intrasternomastoid segment of the spinal accessory nerve, was removed. Two years later, the patient presented with focal neurological deficits. Radiographic findings revealed a well-defined 2.2×2.2×2.2 cm, homogeneously enhancing mass in the left parieto-occipital region of the brain surrounded by significant vasogenic edema and mass effect, culminating in a 1-cm midline shift to the right. The mass was surgically removed. The patient had nearly complete recovery of vision, speech, and memory.Conclusions To our knowledge, this is the first documented case of an MPNST arising from an extracranial segment of the spinal accessory nerve and metastasizing to the brain.
미세혈관감압술과 선택적 경추신경 후근 절단술에 의한 경련성 사경의 외과적 치료 : 증례보고 Case Report
박성찬,이경진,성우현,박영섭,최창락 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.4
A case of spasmodic torticollis in a 48-year-old man was cured by microvascular decompression of the spinal accessory nerve with selective dorsal cervical rhizotomy of the first and second cervical nerves. The 11th nerve was compressed by the posterior inferior cerebellar artery originating from the vertebral artery at the C1 level. After intraoperative identification of each posterior rootlets of C1 and C2 nerves exclusively related with the involved sternocleidomastoid muscle(SCM) using the monopolar electric nerve stimulator, microvascular decompression with selective dorsal cervical rhizotomy was done using the Teflon felt and electrobipolar coagulator.
Neuromuscular Ultrasound of Cranial Nerves
Eman A. Tawfik,Francis O. Walker,Michael S. Cartwright 대한신경과학회 2015 Journal of Clinical Neurology Vol.11 No.2
Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS)which may provide additional value in the assessment of cranial nerves in diferent neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranialnerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of thetechniques, are briefy mentioned in the few reference textbooks available in the feld. Tis review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. Te relevant literatures and potential future applications are discussed.
최기섭(Ki Sub Choi),이형석(Hyung Seok Lee),정진혁(Jin Hyeok Jeong),박인범(In Beom Park),한장희(Jang Hee Han),태경(Kyung Tae) 대한두경부종양학회 2004 대한두경부 종양학회지 Vol.20 No.2
Objective: The aim of this study is to evaluate shoulder function and preoperative and postoperative electrophysiological changes related to the spinal accessory nerve with reference to neck dissection technique. Materials and Methods: We evaluated shoulder function by pain, strength and range of motion in a total of 35 neck dissection cases of 29 patients with head and neck cancer or thyroid papillary cancer. Electrophysiologic studies were performed before surgery, after third postoperative weeks and 6 months respectively. The results of each test according to the types of neck dissection were compared. Results: Clinical parameters of shoulder function and electrophysiologic study showed deterioration in early postoperative periods and improvements in late postoperative periods when the spinal accessory nerve was spared and permanent nerve damage was observed in radical neck dissection. There were correlations between the clinical parameters and electrophysiologic studies. Conclusion: The shoulder function after spinal accessory nerve sparing procedure is better than the function after nerve sacrificing procedure.
Delayed Unilateral Spinal Accessory Neuropathy after Whiplash Injury - A case report -
이진영,윤진원,이주강,박기덕,임오경 대한근전도전기진단의학회 2014 대한근전도 전기진단의학회지 Vol.16 No.1
Unilateral spinal accessory nerve (SAN) palsy is an uncommon pure motor mononeuropathy. Branches of the SAN innervate the sternocleidomastoid and trapezius muscles. Here, the authors describe the case of a 48-year-old man who presented with left shoulder discomfort with shoulder girdle muscle atrophy after a traffic accident. No limitation in any direction was observed in active or passive range of neck motion. However, the patient presented with left shoulder motor weakness on flexion and abduction and limitation of motion; he complained of shoulder pain during forward flexion, abduction, and external rotation. On physical examination, there were no pathologic reflexes, but the patient complained of a tingling sensation in left shoulder concurrent with atrophic sternocleidomastoid and trapezius muscles. An electrodiagnostic study revealed evidence of a unilateral left spinal accessory nerve lesion. The authors report a rare case of isolated unilateral spinal accessory nerve palsy with delayed shoulder pain after whiplash injury.
Isolated Spinal Accessory Nerve Palsy from Volleyball Injury
Cole A. Holan,Brent M. Egeland,Steven L. Henry 대한성형외과학회 2022 Archives of Plastic Surgery Vol.49 No.3
Spinal accessory nerve (SAN) palsy is typically a result of posterior triangle surgery and can present with partial or complete paralysis of the trapezius muscle and severe shoulder dysfunction. We share an atypical case of a patient who presented with SAN palsy following an injury sustained playing competitive volleyball. A 19-year-old right hand dominant competitive volleyball player presented with right shoulder weakness, dyskinesia, and pain. She injured the right shoulder during a volleyball game 2 years prior when diving routinely for a ball. On physical examination she had weakness of shoulder shrug and a pronounced shift of the scapula when abducting or forward flexing her shoulder greater than 90 degrees. Manual stabilization of the scapula eliminated this shift, so we performed scapulopexy to stabilize the inferior angle of the scapula. At 6months postoperative, she had full active range ofmotion of the shoulder. SAN palsy can occur following what would seem to be a routine volleyball maneuver. This could be due to a combination of muscle hypertrophy from intensive volleyball training and stretch sustained while diving for a ball. Despite delayed presentation and complete atrophy of the trapezius, a satisfactory outcome was achieved with scapulopexy.
Spinal Accessory Nerve Injury Induced by Manipulation Therapy: A Case Report
윤정로,김용기,고윤담,윤수인,송대헌,정명은 대한재활의학회 2018 Annals of Rehabilitation Medicine Vol.42 No.5
Spinal accessory nerve (SAN) injury mostly occurs during surgical procedures. SAN injury caused by manipulation therapy has been rarely reported. We present a rare case of SAN injury associated with manipulation therapy showing scapular winging and droopy shoulder. A 42-year-old woman visited our outpatient clinic complaining of pain and limited active range of motion (ROM) in right shoulder and scapular winging after manipulation therapy. Needle electromyography and nerve conduction study suggested SAN injury. Physical therapy (PT) three times a week for 2 weeks were prescribed. After a total of 6 sessions of PT and modality, the patient reported that the pain was gradually relieved during shoulder flexion and abduction with improved active ROM of shoulder. Over the course of 2 months follow-up, the patient reported almost recovered shoulder ROM and strength as before. She did not complain of shoulder pain any more.