Occipital condyle fracture in a patient with neck pain

Abstract

BackgroundOccipital condyle fractures (OCF) are rare traumatic injuries and are of critical clinical importance because of the anatomic considerations of the occipitoatlantoaxial joint complex. OCF can be a diagnostic challenge because of the inability to diagnose this injury with plain radiographs. This is especially true in the emergency department (ED) setting. A high degree of clinical suspicion and careful investigation of the craniocervical junction is warranted in patients presenting to the ED with head and cervical trauma.FindingsWe present a case of a 45-year-old male who presented to the ED with complaints of neck pain and headache four days after an assault. The classification, clinical presentation, diagnosis, and management of his injury are discussed, and pertinent literature is reviewed.ConclusionsOCF can be easily overlooked due to multiple factors; including the conscious state of the patient or the inability to diagnose it through plain radiographs. Early recognition and diagnosis of OCF is crucial to prevent neurological involvement.

Occipital Condylar Fracture with Isolated Unilateral Hypoglossal Nerve Injury: A Case Report

“…Neck pain may be the only presenting symptom. Neurological deficits may, however, be present in some cases, 3 as it was presented in our patient. Because of the close proximity of occipital condyles with the hypoglossal canal and jugular foramen, lower cranial nerves can be affected.…”

“…OCF are diagnosed twice as often in males than in females, with mean age at presentation between 32 and 33 years. 3 Our patient was a 24-year-old male. The clinical presentation of OCF is varied and can be easily missed.…”

Occipital condyle fracture as a rare cause of shoulder pain

“…According to this classification, fracture in our case is involved in type 1. It is known that treatment of stable OCFs (Type 1 and 2) is conservative [2]. Our case was also treated conservatively with close follow-up performed by the neurosurgery.…”

“…The anatomical localization of the OCF is closely related to the complaint and clinical findings of the patient on admission. Patients with OCF may present either with complaints such as headache, neck pain, limitation of the occipitocervical movements, acute torticollis, respiratory failure due to retropharyngeal hematoma and alteration in the mental status, or secondary to trauma without any complaints [2][3][4][5]. In our case, the patient was admitted to our ED due to shoulder pain due to motor vehicle accident.…”

“…Especially in the emergency department (ED) setting, diagnoses of OCFs pose a challenge due to lack of diagnosis [2]. In patients with trauma to head and neck, suspicion of the clinician is the mainstay of diagnosis of OCF.…”