Presentation
The history of prolonged labor or difficult delivery may be present in many cases. The presentation usually is asymptomatic neck swelling or mass in neonates. In some cases, torticollis may be present. [jcnonweb.com]
We report herein two cases of spontaneous neck haematoma in a 19-month-old girl and a 30-month-old boy who initially presented with neck swelling. Case presentation Case 1. [bmcpediatr.biomedcentral.com]
An 8-page color insert presents over 40 photos that visually demonstrate key assessment findings for ear, skin, and other conditions. NEW! [books.google.com]
It typically presents a few weeks after birth. Presentation is usually with torticollis and is most frequently related to birth trauma (e.g. forceps delivery) or malposition (e.g. breech) in the womb. [radiopaedia.org]
No evidence of trauma is present on the face. Physical findings for peripheral nerve injuries are asymmetrical facies with crying. Sometimes evidence of forceps marks is present. [emedicine.medscape.com]
Entire Body System
- Swelling
Mother noticed a swelling on the right side of neck and hence baby was referred for USG neck. [jcnonweb.com]
A 4.5 × 3.5 cm spherical swelling was seen on the trapezius in the posterior triangle of the left side of the neck and the skin over the swelling was normal (Figure 1 ). [bmcpediatr.biomedcentral.com]
Best Wishes, Pablo Prichard, MD A: Swelling or fluid Hello, Thank you for the question and photo. The fullness that you have identified in the photo can be fluid or swelling. [realself.com]
Immediately after the injury, the patient was initially breathless, but as the breathlessness quickly resolved, the swelling rapidly progressed. [mydigimag.rrd.com]
While not every hematoma is life threatening, the following are a list of the most serious types: Caput Succedaneum – This refers to swelling of the soft tissues on a baby’s head and scalp. [thecplawyer.com]
- Falling
[…] idiopathic arthritis Osteoid osteoma Benign paroxysmal torticollis Ocular torticollis ALERT If trauma or subluxation suspected, immobilize cervical spine immediately DIAGNOSIS History Sudden onset of neck pain and distress upon awakening from sleep Minor falls [urgentcarepeds.org]
She explained how they tilt your body and there are shoulder harnesses that keep you from falling off the table. She is certain that this is when it occured and I am too. It would explain why I didn't know how I hurt my shoulder. [ehealthforum.com]
He had sustained an injury while snowboarding; he had rapidly turned his head and body to the left in an attempt to prevent a right-sided fall. He described the sensation in his neck as a painful tearing in the right side of his neck. [mydigimag.rrd.com]
Compartment syndrome Post fasciotomy for post fracture compartment syndrome Compartment syndrome is a limb-threatening and life-threatening condition observed when perfusion pressure falls below tissue pressure in a closed anatomic space. [radiologyassistant.nl]
- Weakness
For the spinal accessory nerve (CN XI), this would result in weak actions of sternocleidomastoid and trapezius muscles. [premedicaluniversity.com]
Other birth injuries include nerve damage, such as brachial plexus injury and facial nerve palsy, which may cause temporary muscle weakness or paralysis. [amboss.com]
[…] intracranial hemorrhaging Brain infection; Jaundice; Anemia; Brain damage, including developmental delay, seizure disorders, paralysis, mental retardation and Cerebral Palsy; Hypotension; Brain death; Labored breathing; Sluggishness; Convulsions; One-sided weakness [thecplawyer.com]
The infant may survive with weakness and hypotonia, and the true etiology may not be recognized. A neuromuscular disorder or transient hypoxic ischemic encephalopathy may be considered. [emedicine.medscape.com]
Motor weakness and muscle wasting may be present, as well as sensory abnormalities. Patients may also complain of neck pain and/or radicular symptoms, so careful evaluation must be done to determine the exact cause of symptoms. [clinicalgate.com]
- Fatigue
[…] and Invisible Illness - Exploring the fatigue that accompanies depression, Sjogren's syndrome and other invisible illnesses. [pinterest.cl]
Pain and fatigue should guide the progression. Once discharged from the hospital, the patient will be instructed to protect the cervical region. [clinicalgate.com]
- Ecchymosis
The accepted alternative is a cesarean delivery. [3] Injuries with a favorable long-term prognosis Soft tissue injuries with a favorable long-term prognosis include the following (see the image below): Abrasions Erythema petechia Ecchymosis Lacerations [emedicine.medscape.com]
Respiratoric
- Cough
Coughing up blood. Hoarseness. Drooling. Shortness of breath. Pain with palpation to the affected area or secondary to coughing or swallowing Crepitus, which is the finding of air in the soft tissue. Resistance to passive maneuvers of the neck. [autoaccident.com]
There was no history of trauma, cough, excessive muscular strain or iatrogenic injury. She was not on any anticoagulants or antiplatelet drugs. The general examination was normal. [bmcpediatr.biomedcentral.com]
Patients often describe a history of trauma, such as a traffic accident or sports injury, or even a simple act such as coughing, vomiting, or sneezing. [mydigimag.rrd.com]
Gastrointestinal
- Nausea
Autonomic symptoms such as increased perspiration or nasal secretions, hyperemia, nausea and dizziness are also associated with trigger points. Clinically trigger points can be identified by examining signs, symptoms and by manual palpation. [special-tests.com]
She denied fevers, chills, nausea, emesis, or photophobia or other pain. She denied numbness or tingling in shoulders or arms. [pediatriceducation.org]
However, the onset of fever, nausea and lethargy prompted him to seek medical attention. His medical history was unremarkable except for a dental infection requiring a right mandibular tooth extraction three weeks ago. [bjid.org.br]
Eyes
- Strabismus
Pediatric compensatory etiologies may include the following: Strabismus with fourth cranial nerve paresis Congenital nystagmus Posterior fossa tumor Central etiology in adults and children Torticollis often presents as a dystonic reaction secondary to [emedicine.medscape.com]
Musculoskeletal
- Torticollis
What is torticollis? Torticollis, also called “wry neck” is a condition where the child’s head is tilted to one side. It is usually detected at birth or up to 6 months of age. What causes torticollis? There may be more than one cause of torticollis. [senderspediatrics.com]
Biterminal tenotomy for the treatment of congenital muscular torticollis. Long-term results. Benign paroxysmal torticollis of infancy. Muscular torticollis. A modified surgical approach. Congenital muscular torticollis. A long-term follow-up. [wheelessonline.com]
What is congenital muscular torticollis? Congenital muscular torticollis is a condition in which an infant's neck muscle is shortened causing the neck to twist. Congenital means present at birth and torticollis means twisted neck. [stanfordchildrens.org]
[…] and acquired types of torticollis [Table 3]. [mjdrdypu.org]
Presentations of torticollis or cervical dystonia are often defined using causal terms—acute torticollis, congenital torticollis, chronic torticollis, or acquired torticollis, idiopathic or secondary. [emedicine.medscape.com]
- Myopathy
Separate arterial supplies predispose to ischemia in the sternal head, resulting in focal myopathy and fibrosis. Get access to the full text of this article [onlinelibrary.wiley.com]
Abnormal head positioning in utero or difficult birth can lead to development of the compartment syndrome and congenital muscular torticollis sequela.Acquired SCM torticollis, can be post traumatic, myopathy induced, post infectious, drug induced, neurological [physio-pedia.com]
[…] basic patterns of abnormality is present: Abnormal anatomy with normal signal, i.e. accessory muscle Muscle atrophy, i.e. too much fat Muscle edema, i.e. too much water while retaining normal architecture due to muscle injury, myositis and imflammatory myopathy [radiologyassistant.nl]
- Muscle Contracture
The anatomy of the SCM muscle and important surrounding structures is shown in FIG 1. PATHOGENESIS The etiology of CMT in infants is contracture or shortening of the SCM muscle. FIG 1 • Anatomy of SCM muscle and important surrounding structures. [musculoskeletalkey.com]
Upper respiratory and soft-tissue infections of the neck can cause an inflammatory torticollis secondary to muscle contracture or adenitis. [emedicine.medscape.com]
Neurologic
- Irritability
Learn more: http://www.kassmd.com A: Neck bumps after facelifts There are a couple of things that will form swelling in your neck within the first post op week, including a small hematoma, a seroma, or irritation and/or focal thickening from some of the [realself.com]
[…] neck caused by contraction of the sternocleidomastoid muscle ; can be acquired or congenital ( congenital muscular torticollis ) Pathomechanism of acquired torticollis Sternocleidomastoid or trapezius muscle injury Cervical muscle spasm Cervical nerve irritation [amboss.com]
During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which of the following would be most appropriate to institute? a. Limiting conversation with the child b. Keeping extraneous noise to a minimum c. [nclexonline.com]
The muscle is irritated as illustrated by edema in the gastrocnemius (arrows). Because there is a delay in symptoms, patients are not always aware of when or how the injury was actually caused. [radiologyassistant.nl]
Benign paroxysmal torticollis is a self-limited condition common in infants characterized by repetitive episodes of head tilting with vomiting, pallor, irritability, ataxia, or drowsiness and usually presents in the first few months of life. [emedicine.medscape.com]
- Ataxia
[…] subluxation Facial asymmetry if congenital or long-standing AARS: SCM spasm on ipsilateral side of chin tilt, tenderness of C2 spinous process, change in nasal resonance, unilateral occipital pain Fever, drooling, stridor suggests RPA Headache, vomiting, ataxia [urgentcarepeds.org]
Ataxia and confusion b. Sodium depletion c. Tonic-clonic seizure d. Urinary incontinence 6. Which of the following signs and symptoms of increased ICP after head trauma would appear first? a. Bradycardia b. Large amounts of very dilute urine c. [nclexonline.com]
Benign paroxysmal torticollis is a self-limited condition common in infants characterized by repetitive episodes of head tilting with vomiting, pallor, irritability, ataxia, or drowsiness and usually presents in the first few months of life. [emedicine.medscape.com]
- Myelopathy
Cervical spondylotic myelopathy ( Figs. 14-1 and 14-2 ) may occur with gait abnormalities, hand clumsiness, or upper motor neuron signs. [clinicalgate.com]
- Hyperreflexia
Typical examination findings include upper motor neuron signs and hyperreflexia manifested as a positive Hoffman reflex, clonus of deep tendon reflexes, and an upgoing Babinski reflex. [clinicalgate.com]
- Agitation
Axoplasm is a viscous substance and is thixotropic, which means that it needs constant agitation or it will gel. 22 – 24 Thus care must be taken to encourage movement and gliding of the nerve, but at the same time, positions that place tension on the [clinicalgate.com]
Workup
Workup Workup consists of radiographic studies of the shoulder and upper arm to rule out bony injury. The chest should be examined to rule out associated phrenic nerve injury. [emedicine.medscape.com]
History and physical examination remain the most important processes in the diagnostic workup. Imaging and electromyography or nerve conduction studies can be used to supplement the diagnostic workup. [clinicalgate.com]
Treatment
This case should suggest caution in thrombolytic treatment in patients with chronic immune dysregulation and vascular inflammation such as extra-pulmonary tuberculosis. [ncbi.nlm.nih.gov]
Discussion The treatment of IS is a course of treatment and prevention of the aggravation [ 3 - 5 ]. An idiopatic scoliosis under 20° Cobb is considered exclusively a physiotherapic treatment [ 17 ]. [omicsonline.org]
A Prospective Study of 821 Cases - Operative Treatment: - indications for surgery: - failure of non operative treatment after 12 to 24 months of age, surgical intervention is needed to prevent further facial deformity; - involves resection of portion [wheelessonline.com]
Surgical treatment is rarely required. [amboss.com]
The symptoms and the treatment for this complication are the same as in the case of peritonsillar abscess. Deep neck infections are not so frequent. [ic.steadyhealth.com]
Prognosis
[…] guidelines for determining prognosis are available. [emedicine.medscape.com]
The prognosis of birth traumas is usually favorable, with most injuries resolving spontaneously within weeks to months. [amboss.com]
Treatment and prognosis It is a self-limiting condition and usually resolves within 4-8 months 3 and requires no more than physiotherapy. For a general differential see: differential diagnosis of pediatric cervical lesions. [radiopaedia.org]
Discharge instructions and medications NSAIDS Short course of benzodiazepine Cervical collar (soft or rigid) for comfort Activity Limit activity until resolved Patient Monitoring Follow up in 1 week If not resolved, needs further evaluation for other causes PROGNOSIS [urgentcarepeds.org]
Etiology
In our document the patients after evaluation of radiologic examinations, no certain diagnosis could be made; we thought that the patient might be experiencing spontaneous neck hematomas with unknown etiology. [bmcpediatr.biomedcentral.com]
Etiology Because idiopathic cervical dystonia is a neurodegenerative process, the confluence of etiologic factors in modern popular explanations applies here as it does in idiopathic Parkinson disease. [emedicine.medscape.com]
[…] chapter will focus on acquired torticollis, not congenital PATHOPHYSIOLOGY Injury or inflammation of sternocleidomastoid (SCM) or trapezius muscle Most common in school age children Acute infection with referred pain to SCM or compensatory muscle spasm ETIOLOGY [urgentcarepeds.org]
PATHOGENESIS The etiology of CMT in infants is contracture or shortening of the SCM muscle. FIG 1 • Anatomy of SCM muscle and important surrounding structures. [musculoskeletalkey.com]
Epidemiology
[9] Facial nerve palsy due to birth trauma Neonatal brachial plexus palsy Shoulder dystocia Definition : an obstetric emergency in which the anterior shoulder of the fetus becoming impacted behind the maternal pubic symphysis during vaginal delivery Epidemiology [amboss.com]
Epidemiologic aspects of shoulder dystocia-related neurological birth injuries. Arch Gynecol Obstet. 2014 Sep 11. [Medline]. [Guideline] Narakas AO. The Paralysed Hand. Edinburough: Churchill Livingstone; 1987. [emedicine.medscape.com]
Pathophysiology
DESCRIPTION Lateral twisting or rotation of neck; also called wryneck This chapter will focus on acquired torticollis, not congenital PATHOPHYSIOLOGY Injury or inflammation of sternocleidomastoid (SCM) or trapezius muscle Most common in school age children [urgentcarepeds.org]
Up to 20% of children with congenital muscular torticollis have congenital dysplasia of the hip as well. [13, 14, 15, 16, 17, 18, 19] Acquired torticollis The pathophysiology of acquired torticollis depends on the underlying disease process. [emedicine.medscape.com]
Pathophysiology And Clinical Evaluation Cervical spondylosis is a progressive degenerative cascade that occurs with aging. [clinicalgate.com]
Prevention
Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. Página 84 - Tanner JM, Whitehouse RH, Marubini E, Resele LF. The adolescent growth spurt of boys and girls of the Harpenden growth study. [books.google.es]
Get optimal test results with guidance on error detection, correction, and prevention as well as cost-effective test selection. [books.google.com]
Phase III: Gliding of the neural tissue through the surgical site to prevent the formation of adhesions should be promoted. [clinicalgate.com]
The prevention of this symptom during surgery is therefore important. The main method for prevention is the interposition of a graft between the skin flap and the parotid bed during surgery. [cochranelibrary.com]