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[Neck pain: when is it ominous?]

Maaike F Nijhoff1, Marjon F G van der Meulen2, Lucianne C M Langezaal3

  • 1OLVG, afd. Neurologie, Amsterdam.

Nederlands Tijdschrift Voor Geneeskunde
|July 28, 2022
PubMed
Summary
This summary is machine-generated.

Acute severe neck pain can signal serious neurological conditions like vertebral artery dissection or cervical epidural hematoma. Prompt medical evaluation is crucial for patients experiencing neck pain with alarming symptoms.

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Area of Science:

  • Neurology
  • Vascular Medicine
  • Emergency Medicine

Background:

  • Acute severe neck pain is a critical symptom that can indicate underlying serious neurological or vascular pathologies.
  • Prompt diagnosis and management are essential to prevent severe patient outcomes.

Purpose of the Study:

  • To highlight the diverse neurological presentations associated with acute severe neck pain.
  • To emphasize the importance of recognizing neck pain as a potential indicator of emergent conditions.

Main Methods:

  • Case series analysis of three patients presenting with acute severe neck pain.
  • Clinical evaluation, diagnostic imaging, and etiological investigation.

Main Results:

  • Patient 1: Vertebrobasilar infarction secondary to bilateral vertebral artery dissection, presenting with autonomic dysfunction, aphagia, and dysarthria.
  • Patient 2: Subarachnoid hemorrhage presenting initially with severe neck pain, with no aneurysm identified.
  • Patient 3: Acute spontaneous cervical epidural hematoma causing hemiparesis and subsequent paraparesis.

Conclusions:

  • Acute severe neck pain, especially with neurological deficits or alarm symptoms, warrants urgent referral to an emergency department.
  • Neck pain can be the primary symptom of critical conditions including vertebral artery dissection, subarachnoid hemorrhage, and cervical epidural hematoma.