Spinal accessory nerve palsy due to neurovascular compression. Report of a case diagnosed by magnetic resonance imaging and magnetic resonance angiography.
The case of a young patient with left accessory nerve paralysis is reported. He had slight tilting of the head to the right side, developed over a period of about 6 months. On neurological examination hypotrophy of the left sternocleidomastoid and trapezius muscles was observed. MRI and MR-angiography imaged the presence of a neurovascular compression between the medulla oblungata, at the level of the nerve entry zone, and a vessel loop of an elongated left vertebral artery. In spite of the absence of a surgical demonstration it is our opinion that the neurovascular conflict is the cause of the accessory nerve palsy.
Lunardi
P
P
Department of Neurological Sciences, University CLa Sapienza, Rome, Italy.
Mastronardi
L
L
Farah
J O
JO
De Biase
C
C
Trasimeni
G
G
Gualdi
G F
GF
D000055:Accessory Nerve / Q000473:pathology; D000293:Adolescent; D003389:Cranial Nerve Diseases / Q000175:diagnosis*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000098:blood supply / Q000473:pathology; D009334:Neck Muscles / Q000294:innervation / Q000473:pathology; D009408:Nerve Compression Syndromes / Q000175:diagnosis*; D010243:Paralysis / Q000175:diagnosis*; D014103:Torticollis / Q000175:diagnosis*; D014711:Vertebral Artery / Q000473:pathology