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Query: UMLS:C0007859 (neck pain)
 3,931 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nuchal symptoms were found in the majority of 100 consecutive patients with cluster headache. In 10%, pain was experienced in the neck with the initial typical orbitotemporal pain; in 37%, pain radiated from the orbit or temple to the ipsilateral side of the neck. Sometimes, neck pain heralded the onset of the attack by a few minutes. During an attack, neck stiffness was reported in 40% and tenderness in 29%. Movement of the neck, especially flexion, precipitated cluster headache in 9% of patients. This was particularly true of patients with chronic cluster headache. Neck movement aggravated the headache in 16 of 100 patients and an equal number reported amelioration of pain by neck movement, especially extension. The nuchal features did not necessarily accompany every attack and were usually overshadowed by the severity of the typical headache. Nevertheless, symptoms referable to the neck occur more commonly than is generally appreciated.
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PMID:Nuchal features of cluster headache. 237 Jan 35

Fractures of the atlas vertebra are generally considered to be innocuous injuries. A review of 35 patients with C1 fractures treated in the Acute Spinal Cord Injury Unit of Shaughnessy Hospital indicated that long-term morbidity is not as low as was previously thought. Thirteen of 23 patients (56%) followed up a minimum of 1 year post-trauma had significant symptoms of scalp dysesthesia, neck pain, and/or neck stiffness. A classification is presented, and the results of treatment modalities used are reviewed. Based on the findings, the simplest orthosis consistent with appropriate treatment of any of the often associated other spine fractures is recommended. Surgery is reserved for late instability or pain.
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PMID:Fractures of the atlas: classification, treatment and morbidity. 318 89

A series of 18 patients with odontoid fractures due to metastatic cancer were treated at Memorial Sloan-Kettering Cancer Center between 1974--1980. The primary source of cancer was breast (12 cases), lung (two cases), nasopharynx (one case), multiple myeloma (one case), colon (one case), and rhabdomyosarcoma (one case). The clinical features consisted of severe neck pain and neck stiffness in 17 patients; signs of cord compression were noted in only four patients. Tomography and computerized tomography were useful in identifying both the osseous and soft-tissue involvement by tumor. Initial treatment in all patients except those with myelopathy consisted of high-dose steroids, and immobilization in a hard collar. Ten patients were treated with radiation therapy alone; six patients underwent surgical fusion (four before and two after radiation therapy); and two patients died before completion of treatment. Conservatively treated patients were allowed to walk with the support of only a collar following radiation therapy. We believe that the initial management of patients with odontoid fractures secondary to cancer should be high-dose steroids and radiation therapy, unless displacement is marked. Assessment for surgical fusion should be made following radiation therapy, since conservative treatment may suffice in most patients. Early recognition is important so that treatment can be instituted before C1--2 subluxation becomes severe.
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PMID:Treatment of odontoid fractures in cancer patients. 745 32

Fifty-two patients underwent MR imaging and conventional radiography of the neck within 4 days after a hyperextension-flexion injury. The patients also had follow-up investigations during the first 2 years. The images did not reveal any serious lesions in any of them. Based on the main MR and radiographical findings the patients were divided into 4 groups; no findings, posture abnormalities, spondylosis and disc pathology (from MR images) or reduced intervertebral space (from the radiographs). The outcomes of the different groups were compared with reference to neck stiffness, neck pain and headache during a 2-year follow-up period. The patient groups did not correspond completely when diagnosed from MR imaging and radiography. However, patients with pre-existing spondylosis had more symptoms when examined by both modalities. Based on the radiographs, the group with posture abnormalities had significant fewer symptoms than the other groups.
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PMID:MR imaging and radiography of patients with cervical hyperextension-flexion injuries after car accidents. 761 24

Eight horses had forelimb lameness which was considered unrelated to primary forelimb pain, but was associated with radiographic abnormalities of one or more cervical vertebrae. There was no evidence of ataxia or weakness. The degree and character of the forelimb lameness varied between horses. In 4 horses, selective local analgesic techniques were used to rule out lameness associated with pain in the forelimb. In the other 4 horses, radiographic examination of the cervical region was performed on the basis of forelimb lameness seen in conjunction with neck stiffness and/or neck pain. Three horses had marked modelling of the synovial articular facet joints in the caudal cervical region; a 4th horse had modelling and a fracture involving the synovial articulation between the 4th and 5th cervical vertebrae. One horse had abnormalities of the intercentral articulation between the 7th cervical and 1st thoracic vertebrae and a discrete mineralised opacity dorsal to it. Two horses had large lucent zones in a vertebral body. One horse had a fracture of the body of the 7th cervical vertebra. Five horses were humanely destroyed, 2 returned to their previous level of activity after a prolonged period of rest and 1 was still being rested at the time of writing.
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PMID:Forelimb lameness associated with radiographic abnormalities of the cervical vertebrae. 822 74

Three cases of extracranial vertebral artery dissections with upper limb peripheral motor deficit (C5-C6) are reported. Six similar cases were also found in the literature. Central neurological symptoms occurred in five of these nine cases, suggesting the diagnosis of dissection. The peripheral motor or sensorial deficit was strictly isolated in the four other cases, simulating radicular neuralgia due to discopathy or foraminal compression. In case of dissections, a precise analysis of pain is helpful to guide diagnosis; sharp, unbearable, continuous and extended neck pain without nocturnal paroxysms and posterior neck stiffness is typical. Analgesics or anti-inflammatory drugs are ineffective. Peripheral motor deficit is more common than sensory deficit. Recovery was complete in this series. In most cases, the radiculopathy appears to be due to cervical root compression in its extraforaminal course due to the dissection hematoma and rarely to radicular ischemia.
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PMID:[Cervical deficit radiculopathy in 3 cases of vertebral artery dissection]. 989 90

In a typical case of pituitary apoplexy, a patient, who may or may not be known to harbor a pituitary adenoma, suddenly develops a severe headache. The headache may be retro-orbital, frontal, frontotemporal, or diffuse and may be associated with neck stiffness, neck pain, or both. Ophthalmoplegia may develop within a few hours after the onset of headache. Here we report a rare case of one middle-aged female with pituitary apoplexy initially presenting with acute onset of pupil-involved third cranial nerve palsy, headache and peri-ocular pain. Emergent neuroimaging revealed pituitary apoplexy and immediate intravenous corticosteroid was given and third nerve paresis was improved thereafter. Definite tumor removal was done smoothly after steroid treatment and complete recovery of ophthalmoplegia was noted 2 weeks after operation.
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PMID:Acute painful oculomotor nerve paresis caused by pituitary apoplexy--a case report. 1046 26

This is a cross-sectional study on the use of halovest appliance in the Orthopaedic and Traumatology Department, Kuala Lumpur Hospital from June 1993 to September 1996. Fifty-three patients with cervical spine injuries were treated by halovest stabilization. Majority of cases was caused by motor-vehicle accident; others were fall from height at construction sites, fall at home, hit by falling object and assault. The injuries were Jefferson fracture of C1, odontoid fractures, hangman fractures, open spinous process fracture and fracture body of C2, and fracture, and fracture-dislocation of the lower cervical spines. Majority of patients had hospital stay less than 30 days. The use of the halovest ranges from 4 to 16 weeks and the healing rate was 96%. Two patients of lower cervical spine injury had redislocation and one of them was operated. There was one case of non-union of type II odontoid fracture and treated by posterior fusion. Other complications encountered during halovest treatment were minor. They were pin-site infection, pin-loosening, clamp loosening and neck pain or neck stiffness. This method of treatment enables patient to ambulate early and reduces hospital stay. We found that halovest is easy to apply, safe and tolerable to most of the patients.
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PMID:Halovest treatment in traumatic cervical spine injury. 1096 76

Whiplash is a sprain of the ligament with strain of the paraspinal muscles due to acceleration or back acceleration of energy transmitted to the neck. The symptoms are neck pain, neck stiffness, muscular spasm and a multitude of discomforts that affect job-related and activities of daily living. In 2000, the Mexican Social Security System treated more than 15,000 cases of whiplash due to job-related activities. With this information, we organized an expert team in order to develop guidelines using methodology of evidence-based medicine and with a focus on early treatment prescribed by the general practitioner in order for the patient to obtain quick relief and to return the patient to his job and to his daily living activities as soon as possible.
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PMID:[Clinical guideline for rehabilitation of patients with cervical whiplash at the primary care level]. 1599 82

Neck pain is frequent and can be a symptom of numerous differential diagnoses with quite different diagnostic and therapeutic consequences. A 37-year-old woman reported acute neck pain aggravated by movements of the cervical spine and head and by swallowing. Clinical examination showed pronounced neck stiffness. T2-weighted MRI demonstrated high-intensity edema and effusion localized prevertebrally in the area of the superior part of the longus colli muscle. Computed tomography of this region demonstrated prevertebral calcification leading to the diagnosis of retropharyngeal tendinitis. Nonsteroidal antiphlogistic drugs led to rapid improvement of clinical signs and symptoms. Retropharyngeal tendinitis should be considered in patients with acute neck pain.
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PMID:[Retropharyngeal tendinitis. Differential diagnosis in the management of acute neck pain]. 1683 94


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