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Arquivos de Neuro-Psiquiatria
On-line version ISSN 1678-4227
KAWASAKI, MABEL SATOMI; HERNANDEZ-FUSTES, OTTO J.; SCHEER NETO, EMILIO J. and HERNANDEZ-COSSIO, OTTO. Post traumatic spasmodic torticollis. Arq. Neuro-Psiquiatr. [online]. 1998, vol.56, n.2, pp.300-306. ISSN 1678-4227. http://dx.doi.org/10.1590/S0004-282X1998000200023.
Dystonia is a rare consequence of head trauma. We describe one case of post-traumatic spasmodic torticollis and review thirty-one cases reported in the literature. The time course among the head injury and the onset of dystonia ranged from two hours to nine years. Eleven cases had mild head injury and twenty had severe. On CT studies, the most frequent lesion was extradural, subdural and thalamic hemorrhagies; on MRI there were lesions in contralateral basal ganglia or thalamus. In our case, initial CT findings were bilateral hygroma and generalized brain edema. A follow-up CT sixt days after head injury showed cerebral atrophy and MRI scan (one year later) showed cerebral atrophy either. The pathophysiologic mechanisms related to the appearence of dystonia are poorly understood. However, there are evidences suggesting that some dysfunction of lenticulothalamic neuronal circuits plays an important role. The period of time between the head injury and the appearence of post-traumatic dystonia, seems to be related to aberrant central neurons.
Keywords : post-traumatic dystonia; head trauma; spasmodic torticollis.