TORTICOLLIS CAUSED BY NEUROENTERIC CYST OF UPPER CERVICAL REGION

Abstract

Objective: Torticollis is a symptom that can be related to different pathological mechanisms ranging from simple to life-threatening conditions. Here we report a child with torticollis caused by a neuroenteric cyst in the upper cervical region; this is a very rare condition in childhood and in this case, it was successfully resolved by surgery. Clinical presentation: A 2.5 year old boy presented with a 2 month-history of torticollis, he had developed paraparesia 2 weeks before admission. At examination he was found to be quadriparetic. Radiographic study of the cervical spine revealed widening of the cervical canal. Brain and spinal magnetic resonance imaging revealed a hypointense lesion on the T1 at the craniovertebral junction having a compressive effect on the anterior aspect of the brain stem and spinal cord. Intervention: The patient underwent surgery. After craniotomy and opening of the dura, a cystic lesion was seen; clear fluid was aspirated and the cyst wall was removed. Conclusion: Considering the quadriparesis and torticollis, the patient improved significantly within the first few days after surgery. No relapse of symptoms occurred during the follow up period. This is the first case report of a child in whom torticollis was due to a neuroenteric cyst of the upper cervical intradural region. Keywords: Torticollis - Neuroenteric cyst - Child - Quadriparesis