II. Anatomy

  1. Spinal Accessory nerve (CN 11) is vulnerable to injury at the posterior triangle of the neck

III. Causes

  1. Trapezius Trauma
  2. Shoulder Dislocation
  3. Nerve injury during surgical procedures
    1. Radical neck dissection
    2. Cervical node biopsy
    3. Carotid endarterectomy

IV. Symptoms

  1. Generalized Shoulder Pain
  2. Shoulder weakness

V. Signs

  1. Shoulder sags on affected side
  2. Shoulder weak on shrugging
  3. Forward flexion at Shoulder weak overhead
  4. Trapezius atrophy (with longstanding injury)

VI. Management

  1. Physical Therapy
  2. Avoid provocative activities
  3. Surgery is rarely indicated
    1. Consider surgery for Penetrating Trauma with nerve transection
    2. Consider surgery for lack of improvement at 18 to 24 months

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Accessory Nerve Injuries (C0161410)

Definition (MSH) Traumatic injuries to the ACCESSORY NERVE. Damage to the nerve may produce weakness in head rotation and shoulder elevation.
Definition (MSHCZE) Traumatické poranění NERVUS ACCESORIUS. Poškození nervu může vyvolat slabost při otáčení hlavy a zvedání ramene. R
Concepts Injury or Poisoning (T037)
MSH D061227
ICD9 951.6
ICD10 S04.7
SnomedCT 157639004, 90630009
Italian Traumatismo dell' XI nervo cranico, Traumatismo del nervo accessorio, Lesioni del nervo accessorio, Trauma del nervo accessorio
Dutch nervus accessorius letsel, letsel; nervus accessorius, n.accessorius; letsel, Letsel van nervus accessorius, XIde zenuwletsel
French Lésion du nerf accessoire, Traumatisme du onzième nerf, Lésions du 11ème nerf crânien, Lésions du nerf spinal accessoire, Lésions du nerf accessoire, Traumatisme du nerf accessoire, Lésions du XIème nerf crânien, Lésions du nerf crânien XI, Paralysie traumatique du onzième nerf, Neuropathie traumatique du nerf spinal accessoire, Traumatisme du nerf spinal accessoire, Lésions du onzième nerf crânien, Neuropathie traumatique du nerf accessoire, Lésion du nerf spinal (XIème)
German Verletzung des Nervus accessorius, Verletzung des N. accessorius, Elfter Hirnnerv, Verletzungen, Hirnnerv XI-Verletzungen, Verletzungen, elfter Hirnnerv, Nervus accessorius-Verletzungen, Verletzung, Hirnnerv XI, Elfter Hirnnerv, traumatische Laehmung, Nervus accessorius-Trauma, Elfter Hirnnerv, traumatische Lähmung, Verletzung des XI. Hirnnervs
Spanish Lesión traumática del nervio accesorio, Traumatismos del Nervio Accesorio, injuria del nervio espinal, injuria del undécimo par craneal, lesión traumática del nervio espinal (trastorno), lesión traumática del nervio espinal, lesión traumática del undécimo par craneal, Lesión traumática del XI par craneal
Japanese 第11神経損傷, 副神経の損傷, ダイ11シンケイソンショウ, フクシンケイノソンショウ
English accessory nerve injury, traumatic accessory nerve injury, traumatic accessory nerve injury (diagnosis), accessory nerve injury (diagnosis), XIth nerve injury, Injury accessory nerve, Injury of 11th cranial nerve, Injuries, Accessory Nerve, Nerve Injury, Accessory, Neuropathy, Traumatic Accessory, Traumatic Accessory Neuropathy, Accessory Nerve Trauma, Neuropathies, Traumatic Accessory, Palsy, Traumatic Eleventh-Nerve, Traumatic Eleventh-Nerve Palsies, Injury, Cranial Nerve XI, Eleventh-Nerve Trauma, Eleventh Nerve Trauma, Accessory Neuropathy, Traumatic, Accessory Neuropathies, Traumatic, Eleventh Cranial Nerve Injury, Nerve Trauma, Accessory, Accessory Nerve Injuries, Nerve Traumas, Accessory, Trauma, Accessory Nerve, Eleventh-Nerve Traumas, Cranial Nerve XI Injury, Eleventh-Nerve Palsies, Traumatic, Spinal Accessory Nerve Injury, Traumatic Eleventh-Nerve Palsy, Accessory Nerve Traumas, Traumas, Accessory Nerve, Traumas, Eleventh-Nerve, Injury, Accessory Nerve, Traumatic Eleventh Nerve Palsy, Accessory Nerve Injury, Eleventh Cranial Nerve Injuries, Eleventh Nerve Palsy, Traumatic, Palsies, Traumatic Eleventh-Nerve, Spinal Accessory Neuropathy, Traumatic, Nerve Injuries, Accessory, Traumatic Accessory Neuropathies, Eleventh-Nerve Palsy, Traumatic, Injury, Eleventh Cranial Nerve, Spinal Accessory Nerve Trauma, Trauma, Eleventh-Nerve, Accessory Nerve Injuries [Disease/Finding], Accessory nerve injury (disorder), Accessory nerve injury, Injury to accessory nerve, Injury of accessory nerve, Injury of eleventh cranial nerve, Accessory (11th) nerve injury, Eleventh cranial nerve injury, Injury of accessory nerve (disorder), injury; accessory nerve, n.accessorius; injury, Injury to eleventh cranial nerve
Czech Poranění nervus accessorius, Poranění XI. nervu, XI. hlavový nerv - poranění, nervus accessorius - poranění, poranění přídatného nervu
Korean 부신경의 손상
Hungarian Nervus accessorius-sérülés, XI. agyidegsérülés
Portuguese Traumatismos do Nervo Acessório, Lesão traumática do XI nervo
Russian ДОБАВОЧНОГО НЕРВА ПОВРЕЖДЕНИЯ, 11-OGO CHEREPNOGO NERVA TRAVMY, CHEREPNOGO NERVA XI POVREZHDENIIA, 11-ОГО ЧЕРЕПНОГО НЕРВА ТРАВМЫ, DOBAVOCHNOGO NERVA POVREZHDENIIA, ЧЕРЕПНОГО НЕРВА XI ПОВРЕЖДЕНИЯ
Polish Uszkodzenie nerwu dodatkowego, Urazy nerwu dodatkowego
Norwegian Traume mot 11. hjernenerve, Skader på 11. hjernenerve, Skader på nervus accessorius, Traume mot nervus accessorius