An infant with cerebellar tumor presenting with torticollis as the only initial symptom

Torticollis is an usual symptom that can be the result of various disorders, such as sternocleidomastoid muscle pathology, bony abnormalities of the cervical spine, disorders of the central or peripheral nervous system, various ocular diseases, and brain tumors, especially in children. A 12-month-old male visited our hospital because of torticollis. He was normal on systemic examination, with no neurological abnormality, and his cervical spine CT was also normal. About 4 weeks later, he revisited the emergency department due to vomiting with altered mental status, and was diagnosed with a cerebellar tumor with hemorrhage. Although torticollis is known to be an important sign of a posterior fossa tumor, associated neurological or ocular symptoms are usually present. We report here a patient with posterior fossa tumor where torticollis was the only initial presenting symptom. Neurology Asia 2015; 20(4) : 401 – 403 Address correspondence to: Min-Kyun Oh, Department of Rehabilitation Medicine, Gyeongsang National University Hospital & School of Medicine, #79 Gangnam-ro, Jinju 660-702, South Korea. Tel: 82-55-750-8854, Fax: 82-55-750-8255, E-mail: [email protected] INTRODUCTION Torticollis is the abnormal positioning of the head and neck; it can be congenital or acquired. Acquired torticollis in children is caused by wide variety of pathologies, such as cervical bone abnormalities, nasopharyngeal infection, trauma, and ocular disorders. Some of its causes may be more serious, such as tumors of the cervical spinal cord or posterior fossa. Here, we report the case of a 13-month-old child with acquired torticollis who was diagnosed with a posterior fossa tumor one month after the initial visit. This report illustrates the importance of torticollis as a sign of posterior fossa tumor even when there is no other associated symptom. To our knowledge, this is the first reported case of torticollis as the only initial symptom of the posterior fossa tumor in a child.