{"id":"6995165a-15ff-4ada-a066-dc030db6d465","slug":"interscapular-pain-with-chiari-type-i-malformation-attributed-to-atypical-spinal-accessory-neuralgia","title":"Interscapular pain with Chiari Type I malformation attributed to atypical spinal accessory neuralgia","authors":["Anoop Kumar Singh","Gayatri Kumari"],"abstract":"Background: The spinal accessory nerve (XI) is traditionally considered a motor nerve. However, as some studies have documented the presence of nociceptive fibers in XI, vascular XI neural compression may lead to an atypical neuralgia. Case Description: A 27-year-old male presented with a Chiari Type I malformation contributing to interscapular pain. Following a posterior fossa and microvascular decompression of XI, the patient improved, thus confirming the underlying diagnosis of a XI atypical neuralgia. Conclusion: Unilateral, posterior-interscapular deep pain may be due to an atypical spinal accessory nerve (XI) neuralgia rather than a Chiari Type I malformation or syrinx. Posterior fossa decompression, subpial tonsillar resection, and XI nerve microvascular decompression resolved this patient’s complaints. In the future, CTA or MRA vascular studies along with a balanced steady-state gradient echo MRI sequence would be better to document the presence of XI nerve neurovascular compromise.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/6995165a-15ff-4ada-a066-dc030db6d465/featured/hero-cropped-1781562434304.jpg","publishDate":"2021-05-17T00:00:00.000Z","doi":"10.25259/SNI_67_2021","categories":["General Neurosurgery","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/6995165a-15ff-4ada-a066-dc030db6d465/pdf"}