title: The importance of a neck exam in sport-related concussion: Cervical schwannoma in post concussion syndrome.
abstract: OBJECTIVE
  Few cases of cervical schwannoma have been reported following head trauma. The present case, involves a schwannoma of the C2 spinal nerve mimicking post-concussion symptoms following a sport-related concussion (SRC).
  
  
  METHODS
  Case study.
  
  
  METHODS
  University of Calgary, Sport Medicine Clinic, Calgary, Alberta, Canada.
  
  
  RESULTS
  We report a 28 year old, athlete who developed headache, dizziness, photophobia, and neck pain following a cycling accident. She presented nine months later to our sports clinic with persistent symptoms. She had a normal neurological examination but complained of painful neck range of motion, and exacerbation of symptoms with neck extension. On palpation, a lump was found in the right suboccipital muscles and MRI showed a T2 hyperintense mass at the C1-2 level. The patient underwent resection and histology revealed a schwannoma of the C2 nerve root. Following resection her symptoms improved, with no recurrence at 2 months follow up.
  
  
  CONCLUSIONS
  Our patient's slow recovery following SRC is consistent with a schwannoma formation, which may have been precipitated by the injury itself or merely unmasked from trauma. This case illustrates the importance of a thorough physical examination and broad differential in patients presenting with worsening of symptoms after initial improvement in SRC.
authors.affiliation: University of Calgary, Department of Clinical Neurosciences, Division of Physical Medicine and Rehabilitation, Foothills Medical Centre, 1403 29(th) ST. NW, Calgary T2H2T9, Alberta, Canada. Electronic address: dmlangel@ucalgary.ca.
authors.forename: David M
authors.initials: DM
authors.lastname: Langelier
authors.affiliation: Hotchkiss Brain Institute, Calgary, Alberta, Canada; Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Canada; Alberta Children's Hospital Research Institute, Canada. Electronic address: kjschnei@ucalgary.ca.
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Schneider
authors.affiliation: University of Calgary, Department of Clinical Neurosciences, Division of Physical Medicine and Rehabilitation, Foothills Medical Centre, 1403 29(th) ST. NW, Calgary T2H2T9, Alberta, Canada; Hotchkiss Brain Institute, Calgary, Alberta, Canada. Electronic address: jhurlber@ucalgary.ca.
authors.forename: John
authors.initials: J
authors.lastname: Hurlbert
authors.affiliation: University of Calgary, Department of Clinical Neurosciences, Division of Physical Medicine and Rehabilitation, Foothills Medical Centre, 1403 29(th) ST. NW, Calgary T2H2T9, Alberta, Canada; Hotchkiss Brain Institute, Calgary, Alberta, Canada. Electronic address: chantel.debert@gmail.com.
authors.forename: Chantel T
authors.initials: CT
authors.lastname: Debert
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D009333:Neck / Q000503:physiopathology*; D009442:Neurilemmoma / Q000175:diagnosis*; D010808:Physical Examination; D038223:Post-Concussion Syndrome / Q000175:diagnosis*
keywords: Mild traumatic brain injury; Neck pain; Post concussion syndrome; Schwannoma; Sport-related concussion