Related Experiment Video
Updated: Jun 25, 2026
10:34
Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
Hemorrhage in brain stem cavernoma presenting with torticollis.
Amit Agrawal1, Rafael Cincu, S R Joharapurkar
1Department of Surgery, Division of Neurosurgery, Datta Meghe Institute of Medical Sciences, Wardha, India. dramitagrawal@gmail.com
Pediatric Neurosurgery
|March 5, 2009
Summary
A rare case of acute spasmodic torticollis in a child resulted from a brain stem cavernoma after a head injury. This specific presentation following midbrain lesions is previously unreported in medical literature.
Area of Science:
- Neurology
- Pediatric Neurology
- Neurovascular Disorders
Background:
- Spasmodic torticollis is a rare movement disorder characterized by involuntary neck muscle contractions.
- Focal brain stem lesions causing spasmodic torticollis are uncommon, with midbrain lesions being particularly rare in reported human cases.
- Cerebral cavernomas are vascular malformations that can lead to neurological symptoms, including hemorrhage.
Observation:
- A 9-year-old female experienced an acute onset of torticollis immediately following a bicycle accident with loss of consciousness and vomiting.
- Clinical examination suggested a hemorrhage within a brain stem cavernoma as the cause of the acute torticollis.
- The patient's presentation of acute torticollis secondary to a midbrain cavernoma hemorrhage was unique.
Findings:
- The study reports a novel case of spasmodic torticollis in a pediatric patient.
- The etiology was identified as a hemorrhage within a brain stem cavernoma, specifically in the midbrain region.
- This represents the first reported instance of abrupt-onset spasmodic torticollis linked to a midbrain lesion of this nature.
Implications:
- This case expands the known clinical manifestations of brain stem cavernomas in children.
- It highlights the importance of considering vascular lesions in the brain stem for acute-onset torticollis, especially after trauma.
- Further research into the neurovascular mechanisms underlying traumatic cavernoma hemorrhage and subsequent movement disorders is warranted.
Related Concept Videos
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:19Veins of Head and Neck
The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...