Symmetrical Neck Lumps: Possible Neurological Concerns After Injury

Symmetrical hard masses in the neck?

Hello Dr.
Ding: About a week ago, I noticed symmetrical lumps about five centimeters behind my ears (approximately the size of a coin).
These are not external lumps but are located within the posterior neck muscle area.
They have slightly diminished in size, but they still feel hard to the touch.
In January 1995, I was involved in a car accident that resulted in a brain hemorrhage.
I was hospitalized at Linkou Chang Gung Memorial Hospital for a week and later requested to be discharged.
Could you please advise if these symptoms are related to my previous car accident? I also find myself becoming easily irritable and experiencing insomnia at night, having difficulty falling asleep.
Could this be considered a sequela? I would appreciate your insights, Dr.
Ding.

Xiao Hong, 20~29 year old female. Ask Date: 2000/11/20

Dr. Ding Xianwei reply Neurosurgery

The hard lump that has appeared behind your ear is better evaluated by an otolaryngologist for a more accurate diagnosis.
Such tumors can potentially be benign lymphomas or malignant tumors.
Regarding the possibility of post-stroke complications, medication can be used for treatment, but it may not be beneficial for a small percentage of patients.
Therefore, it may be necessary to consult a neurosurgeon for further evaluation and treatment.

Reply Date: 2000/11/20

More Info

The presence of symmetrical neck lumps, particularly in the context of a previous head injury and neurological concerns, warrants careful consideration. Given your history of a car accident that resulted in a brain hemorrhage, it is essential to evaluate whether these new symptoms are related to your past injury or if they represent a separate issue.

Firstly, the lumps you describe, located approximately five centimeters behind your ears, could potentially be lymph nodes that have become enlarged due to various reasons, including infection or inflammation. In some cases, trauma can lead to localized swelling or the formation of scar tissue, which may feel like a lump. However, the fact that these lumps are symmetrical and located in the neck region raises the possibility of a neurological concern, especially considering your medical history.

Neurological symptoms can manifest in various ways following a head injury, including changes in mood, sleep disturbances, and cognitive difficulties. The increased irritability and difficulty sleeping you mentioned could indeed be related to post-concussive syndrome, which can occur after a traumatic brain injury. This syndrome may present with a range of symptoms, including headaches, dizziness, mood swings, and sleep issues, persisting for weeks or even months after the initial injury.

It is crucial to monitor these lumps closely. If they continue to persist, change in size, or are accompanied by other symptoms such as pain, fever, or neurological changes (like weakness, numbness, or changes in vision), it would be advisable to seek further medical evaluation. A healthcare provider may recommend imaging studies, such as an ultrasound or MRI, to assess the nature of these lumps and determine if they are related to your previous injury or if they indicate a new condition.

In terms of managing your irritability and sleep issues, several strategies can be beneficial. Engaging in regular physical activity, practicing relaxation techniques such as deep breathing or meditation, and maintaining a consistent sleep schedule can help improve your mood and sleep quality. Additionally, cognitive-behavioral therapy (CBT) has been shown to be effective for individuals experiencing mood disturbances and sleep difficulties following a head injury.

In conclusion, while the symmetrical neck lumps may not directly indicate a serious neurological issue, they should not be overlooked, especially given your history of a significant head injury. It is essential to consult with a healthcare professional who can provide a thorough evaluation and appropriate management. Monitoring your mood and sleep patterns is equally important, as these can significantly impact your overall quality of life. If symptoms persist or worsen, do not hesitate to seek further medical advice.

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