Severe posttraumatic craniocervical instability in the very young

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Children younger than 3 years of age represent a distinct subpopulation of patients at particular risk for high cervical and craniovertebral injuries. There are few descriptions of survivors of severe craniocervical trauma among the very young, and scarce data exist regarding management after initial emergency stabilization. The authors describe three children, age 1 to 32 months, who presented with craniocervical junction injuries. Variable neurological findings were observed at presentation (cranial nerve deficits, obtundation, and moderate-to-severe quadriparesis). All three were treated with prolonged immobilization and have recovered with minimal to no neurological deficit.