{Reference Type}: Journal Article
{Title}: Contrast-enhanced Magnetic Resonance Imaging in Patients With Dropped Head Syndrome.
{Author}: Endo K;Nishimura H;Sawaji Y;Aihara T;Suzuki H;Konishi T;Nagayama K;Yamamoto K;
{Journal}: Spine (Phila Pa 1976)
{Volume}: 49
{Issue}: 6
{Year}: 2024 Mar 15
{Factor}: 3.241
{DOI}: 10.1097/BRS.0000000000004841
{Abstract}: <B>METHODS: </B>This is a retrospective study of a consecutive case series of dropped head syndrome (DHS).<BR><B>OBJECTIVE: </B>To identify the characteristic features of contrast-enhanced magnetic resonance imaging (MRI) in DHS patients.<BR><B>BACKGROUND: </B>Isolated neck extensor myopathy DHS is thought to be caused by severe cervical extensor muscle weakness from age-related loss of elasticity. However, the MRI findings of the cervical extensor muscles in DHS patients have not yet been characterized.<BR><B>METHODS: </B>The subjects were 34 patients with isolated neck extensor myopathy DHS who underwent contrast-enhanced MRI within seven months after onset and 32 patients with age-matched cervical spondylosis or cervical soft-tissue tumor as controls. The presence of enhanced findings in the cervical extensor muscles, the involved cervical levels, and the characteristically enhanced shape of those muscles were evaluated using contrast-enhanced MRI.<BR><B>RESULTS: </B>In the DHS group, the contrast-enhanced MRI showed pronounced enhancement at splenius capitis in 34 cases, rhomboid in 23 cases, semispinalis cervicis in seven cases, and levator scapulae in three cases. In the non-DHS group, none of those extensor muscles were enhanced. The enhanced pattern was butterfly shaped in 29 cases (85.3%) and linear in five cases (14.7%). All were located at the spinous process attachment at C6 or C7 in the DHS group. In the non-DHS group, seven cases presented an enhanced image of the spinous process, with C5-6 in one case, C6 in five cases, and C7 in one case.<BR><B>CONCLUSIONS: </B>In DHS, contrast-enhanced MRI showed intramuscular enhancement of the cervical extensor muscles, which was not present in non-DHS cases. The enhanced muscles included the splenius capitis muscle in all cases. These findings may be useful for developing a strategy for DHS treatment.