J Clin Neurol.  2011 Sep;7(3):156-158. 10.3988/jcn.2011.7.3.156.

Ipsilateral Tilt and Contralateral Sensory Change of Neck in Cortical Infarction

• Kang SY
• Ma HI
• Lee MJ
• Kwon SB
• Jung S
• Kim YJ
• Hwang SH

• KMID: 2287631
• DOI: http://doi.org/10.3988/jcn.2011.7.3.156

Abstract

BACKGROUND
Numerous neck muscles are involved in neck movements, and so isolated neck weakness is extremely uncommon in cerebral infarction.
CASE REPORT
We report herein the case of a 65-year-old woman with hypertension and acute cortical infarction, presenting with ipsilateral head tilt and contralateral sensory changes in the neck and shoulder area, which has never been described before.
CONCLUSIONS
Transient neck weakness and sensory deficits can occur in acute cortical infarction. The motor representation of the neck muscles can be at the same level of the cortical sensory representation, near to the level of the trunk representation, which is in contrast to Penfield's findings. Several possible mechanisms for the ipsilateral tilt are described.

Keyword

neck; cerebral infarction; cortical representation; motor cortex; magnetic resonance imaging; sternocleidomastoid muscle

MeSH Terms

Aged
Cerebral Infarction
Female
Head
Humans
Hypertension
Infarction
Magnetic Resonance Imaging
Motor Cortex
Neck
Neck Muscles
Shoulder

Figure

• 

  Fig. 1 A: Schematic diagram of the decreased sensation of the patient's neck and shoulder areas. B: Brain diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient map showing a tiny, acute infarction located high up on the cerebral convexity in the right precentral cortex (arrow), a comparable level to the sensory representation of the neck in the postcentral cortex.

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