Illustration of a boxer experiencing dropped head syndrome after a head injury.

Dropped Head Syndrome: When a Blow to the Head Causes Your Head to Drop

Theo Raines in Health & Wellness December 2025 • 4 min read.

"Exploring the rare and dramatic condition of dropped head syndrome resulting from traumatic injury, its diagnosis, and management."

Dropped head syndrome primarily affects older adults and is characterized by the head uncontrollably dropping forward due to weakened neck extensor muscles. Typical causes encompass neurological disorders like amyotrophic lateral sclerosis (ALS), myasthenia gravis, and various myopathies, which often carry a poor prognosis.

However, in a rare twist, cases have emerged where this condition stems from cervical spine injuries, sometimes linked to radiation therapy for lymphoma. These instances challenge conventional understanding and highlight the diverse origins of dropped head syndrome.

This article explores an unusual occurrence of dropped head syndrome following a hyperextension traumatic cervical injury sustained by a Muay Thai boxer. This case underlines the importance of recognizing trauma as a potential trigger for this debilitating condition.

The Case of the Dropped-Head Boxer: A Clinical Overview

Illustration of a boxer experiencing dropped head syndrome after a head injury.

A 25-year-old female Muay Thai boxer experienced a cervical spine injury during a competition. Throughout the bout, her opponent repeatedly used her gloves to forcefully hyperextend her cervical spine, driving her head towards her knee. The athlete immediately felt neck pain and an inability to hold her head upright.

Despite the immediate discomfort, she continued fighting until the referee stopped the match. Post-match, she sought immediate medical attention where initial scans ruled out fractures. Diagnosed initially with a sprain, she was given analgesics and a soft cervical collar. However, the inability to maintain head posture prompted a sports medicine consultation three days later.

Physical Examination Findings: Examination revealed marked anteflexion of the cervical spine, requiring the patient to look downward towards her feet. She could not lift her head on command and reported diffuse neck pain without muscle spasms.
Neurological Symptoms: Neurological assessment showed sensory disturbances, including paresthesia across the left side of her face (V2 and V3 dermatomes), left upper trunk, and both the upper and lower limbs. Reflexes were normal, and cranial nerve function was intact.

Considering the blend of cervical sprain symptoms with neurological indicators, an urgent MRI of the cervical spine was performed. MRI results indicated fluid-like signal abnormalities between the semispinalis capitis and inferior oblique muscles, predominating on the left from C2 to C4-C5. Hypersignals were also noted in the splenius capitis muscles bilaterally from C2 to C4, alongside diffuse edema in the posterior cervical muscles from C2 to C6.

Final Thoughts: Recognizing and Managing Traumatic Dropped Head Syndrome

Traumatic dropped head syndrome, though rare, demands vigilance and specific management strategies. Early diagnosis via MRI and a high index of suspicion for underlying ligamentous injuries are key. Treatment should include cervical immobilization to facilitate muscle healing and prevent further instability. While muscle injuries might not present long-term severe consequences, the potential for associated instability necessitates a cautious and comprehensive approach. Always consider Quebec Task Force recommendations when assessing such injuries to ensure comprehensive care.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.jts.2017.06.001, Alternate LINK

Title: Une Cause Traumatique De Syndrome De La Tête Tombante

Subject: Rehabilitation

Journal: Journal de Traumatologie du Sport

Publisher: Elsevier BV

Authors: A. Schmitt, M. Diger, S. Winter

Published: 2017-09-01

Everything You Need To Know

What is Dropped Head Syndrome?

Dropped Head Syndrome is a condition where a person cannot hold their head upright. It is often seen in older adults and is characterized by the head uncontrollably dropping forward due to weakened neck extensor muscles. It can be caused by neurological disorders like amyotrophic lateral sclerosis (ALS), myasthenia gravis, and various myopathies, which often carry a poor prognosis. However, in rare cases, it can result from cervical spine injuries, as seen in the case of the Muay Thai boxer.

What caused the Dropped Head Syndrome in the Muay Thai boxer?

The dropped head syndrome in the Muay Thai boxer was caused by a hyperextension traumatic cervical injury sustained during a competition. The athlete's opponent repeatedly used her gloves to forcefully hyperextend her cervical spine, driving her head towards her knee, which led to the injury. This highlights the importance of recognizing trauma as a potential trigger for this debilitating condition.

What were the initial treatments and findings after the Muay Thai boxer's injury?

Initially, the boxer was diagnosed with a cervical sprain and treated with analgesics and a soft cervical collar. Immediate scans ruled out fractures. However, the inability to maintain head posture led to a sports medicine consultation. Physical examination showed marked anteflexion of the cervical spine, and the patient couldn't lift her head on command and reported diffuse neck pain. Neurological assessment also revealed sensory disturbances, including paresthesia.

What did the MRI reveal about the boxer's neck injury?

The MRI of the cervical spine indicated fluid-like signal abnormalities between the semispinalis capitis and inferior oblique muscles, predominating on the left from C2 to C4-C5. Hypersignals were also noted in the splenius capitis muscles bilaterally from C2 to C4, alongside diffuse edema in the posterior cervical muscles from C2 to C6. These findings helped pinpoint the muscle injuries and the extent of the damage.

How should Traumatic Dropped Head Syndrome be managed, according to this information?

Management of Traumatic Dropped Head Syndrome requires vigilance and specific strategies. Early diagnosis via MRI and a high index of suspicion for underlying ligamentous injuries are key. Treatment should include cervical immobilization to facilitate muscle healing and prevent further instability. A cautious and comprehensive approach is needed, considering the potential for associated instability. The Quebec Task Force recommendations should be considered when assessing such injuries to ensure comprehensive care.