Horner syndrome associated with contusion of the longus colli muscle simulating a tumor.
A 22-year-old man who was discovered unarousable after an accidental methadone overdose complained of worsening neck pain and left arm weakness over the next week. Examination disclosed a left Horner syndrome and a left brachial plexopathy. Imaging showed a left paraspinal mass adjacent to the sympathetic pathway at the fourth and fifth cervical vertebral levels with imaging features of a tumor. Biopsy was deferred. One month later, the imaging abnormality had nearly disappeared. In retrospect, it represented a contusion injury of the longus colli muscle, a finding not reported previously. Whether it caused the Horner syndrome or was merely a bystander in cervical neck trauma is uncertain. This abnormality should be recognized as a diagnostic confounder.
Ibrahim
Mohannad
M
Department of Radiology (Neuroradiology), University of Michigan Medical System, Ann Arbor, Michigan 48109, USA. mibrahim@umich.edu
Parmar
Hemant
H
Yang
Lynda
L
D020516:Brachial Plexus Neuropathies / Q000150:complications; D003288:Contusions / Q000150:complications; D006732:Horner Syndrome / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D019042:Muscle Neoplasms / Q000503:physiopathology*; D013116:Spinal Cord; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult