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Spinal injuries
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Atlanto-occipital dislocation was at one time a post-mortem diagnosis but improved recovery and resuscitation methods permit survival in some cases. It usually results from high-energy acceleration/deceleration forces, as occurr in road traffic collisions. It is more common in children. Many victims display lower cranial nerve or brainstem signs, as well as profound cord deficits, often requiring ventilator support. The injury is unstable, requiring external or internal fixation.
Craniovertebral Junction Anomalies
Published in Swati Goyal, Neuroradiology, 2020
Atlanto-occipital dislocation− marked flexion or extension at the upper cervical level result in complete disruption of all the ligaments between the occiput and the atlas, with immediate death ensuing from stretching of the brainstem (respiratory arrest). Cervical traction is contraindicated.
Atlanto-occipital dislocation case
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
This patient is presenting with an atlanto-occipital dislocation. This is a rare and devastating injury, wherein there is disruption of ligaments connecting the base of the skull (i.e. occiput) from the C1 vertebral body (i.e. atlas). The most common mechanism is high-speed motor vehicle accidents and children are disproportionately affected due to the relatively larger size of their heads in relation to their bodies.
Integrity of the tectorial membrane is a favorable prognostic factor in atlanto-occipital dislocation
Published in British Journal of Neurosurgery, 2020
Gil Kimchi, Gahl Greenberg, Vincent C. Traynelis, Christopher D. Witiw, Nachshon Knoller, Ran Harel
Atlanto-occipital dislocation (AOD) is considered to be a frequently fatal injury with a substantial risk for severe neurological deficits. To date, numerous publications have centered on identifying prognostic factors in this population.1,2 Mostly, they are based on clinical indicators at presentation such as Glasgow Coma Scale (GCS), Injury Severity Score (ISS), the presence of traumatic brain injury (TBI) and hemodynamic status.3,4 Seldom, radiographic parameters were established as predictors for clinical outcome. Some that have been established include a Basion-Dental Interval (BDI) greater than 16 mm3 and a radiographic evidence of a Traynelis Type II dislocation.2,5 The aim of this study is to illustrate a novel prognostic factor in atlanto-occipital dislocation, based on cervical MRI studies in a small case series of patients who suffered this injury.