Abstract
Atlanto-occipital dislocation (AOD) is the most common cervical spine injury in motor vehicular accident fatalities. It carries a high morbidity and mortality. Diagnosis of this injury is difficult and requires a high index of clinical suspicion combined with careful examination of imaging modalities. A 22-year-old female was in a motor vehicle accident and was found unresponsive. She sustained multiple injuries requiring emergency laparotomy and damage control laparotomy. CT of Cervical spine was initially read as negative. Ten days later, the patient had no movement of her lower extremities. It was discovered that craniocervical dissociation was missed on the CT done on admission; CT angiogram done to rule out blunt carotid and vertebral artery injury showed realignment of the spine. The patient underwent surgery and recovered the use of her legs. Spontaneous realignment pre-operatively for AOD has not been reported in the literature because most cases underwent immediate surgery for stabilization.
Highlights
Atlanto-occipital dislocation (AOD) is a devastating and highly unstable cranio-cervical injury caused by high impact trauma, usually in the form of a motor vehicle accident (MVA)
AOD accounts for 6-8% of all motor vehicle accident fatalities and is the most common cervical spine injury in motor vehicle accident fatalities [1]
The basion dens interval (BDI) measures the distance between the basion and dens, and it is positive for AOD when the BDI >12 mm [1]
Summary
Atlanto-occipital dislocation (AOD) is a devastating and highly unstable cranio-cervical injury caused by high impact trauma, usually in the form of a motor vehicle accident (MVA). AOD accounts for 6-8% of all motor vehicle accident fatalities and is the most common cervical spine injury in motor vehicle accident fatalities [1]. It is often associated with high morbidity and mortality. This often-fatal injury has increased survival with improved pre-hospital care, immediate inline cervical stabilization, prompt diagnosis, and proper treatment. The occipital condyles articulate with the lateral masses of C1 Ligaments such as the tectorial membrane, alar ligaments, Barkow ligament, and the cruciate ligament all play a role in structural support [1]. Neurogenic shock may be the presenting symptom which can delay diagnosis and treatment
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of Rare Disorders: Diagnosis & Therapy
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
