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Torticollis secondary to posterior fossa tumors
A K Gupta1, D R Roy, E S Conlan
1Department of Orthopaedic Surgery, Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Abstract:
Torticollis in childhood may be a sign of many disorders. Five cases, with torticollis as the initial sign of a posterior fossa tumor, are presented. The diagnosis and treatment of the tumor was considerably delayed in all patients because posterior fossa tumor was not considered in the initial differential diagnosis. In two patients, operative procedures on the sternocleidomastoid muscle were performed before discovering the underlying causative tumors. Four of the five patients also had other associated symptoms such as headache, nausea, and vomiting. It is stressed that in acquired torticollis, posterior fossa tumor be considered in the differential diagnosis.
Insights
Torticollis in children can indicate serious conditions like posterior fossa tumors. Early diagnosis is crucial, as delays in identifying these brain tumors can lead to delayed treatment.
Area of Science:
- Pediatric Neurology
- Neuro-oncology
- Surgical Pediatrics
Background:
- Torticollis, or wryneck, is a common pediatric condition that can stem from various underlying causes.
- Acquired torticollis in children warrants a thorough diagnostic evaluation to rule out serious pathologies.
- Posterior fossa tumors are a rare but critical differential diagnosis for acquired pediatric torticollis.
Observation:
- This study presents five pediatric cases where torticollis was the initial presenting symptom of a posterior fossa tumor.
- Diagnosis and treatment were significantly delayed in all cases due to the tumor not being considered initially.
- Two patients underwent unnecessary sternocleidomastoid muscle surgery before the underlying tumor diagnosis.
Findings:
- Acquired torticollis in children can be an early indicator of a posterior fossa tumor.
- Failure to include posterior fossa tumors in the differential diagnosis leads to diagnostic delays.
- Associated symptoms like headache, nausea, and vomiting were present in four of the five patients.
Implications:
- Clinicians should consider posterior fossa tumors in the differential diagnosis of acquired torticollis in children.
- Prompt neuroimaging is essential for children presenting with acquired torticollis, especially with associated neurological symptoms.
- Timely diagnosis and surgical intervention for posterior fossa tumors can improve patient outcomes.