The pathological findings in fatal craniospinal injuries

Davis, Donald D.; Bohlman, Henry H.; Walker, Andrea; Fisher, R M; Robinson, Reginald Leamon

doi:10.3171/jns.1971.34.5.0603

Cited by 125 publications

(42 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…C1-C2 dissociation occurs with complete ligament lesion [1,5]. It is possible to speculate that the lesion occurred at the moment of the trauma, well before the traction.…”

Section: Discussionmentioning

confidence: 99%

“…Most of these ligaments involved the atlantoaxial region [5]. In a postmortem study of 14 patients who presented atlantoaxial displacement, Adams [1] identified three patients with complete rupture of the atlantoaxial ligament and of the tectorial membrane and lesion of atlantoaxial capsulae associated with type II odontoid fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Few reports about longitudinal distraction vector control in the C1-C2 articulation are available in the literature. In one reported series of fatal lesions [5], there was a case of craniocervical trauma in which the alar ligament was disrupted, showing the effect of longitudinal distraction associated with flexion-extension in severe trauma.…”

Section: Discussionmentioning

confidence: 99%

“…Anatomical pathology studies of fatal craniocervical injuries show that the most frequently injured site is C2. Davis and co-workers [5] studied 50 cases of fatal craniocervical trauma. Of these, 36 showed evidence of cervical lesion and 18 presented ligament lesion.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Traumatic vertical atlantoaxial instability: the risk associated with skull traction. Case report and literature review

Botelho¹,

Palma

Abgussen

et al. 2000

European Spine Journal

View full text Add to dashboard Cite

IntroductionThe stability of the atlantoaxial motion segment is unique. The lack of typical vertebral bodies and the arrangement of articular facets without protection against horizontal gliding make the articular system dependent mostly on the ligaments. Anterior C1-C2 dislocation is a rare and severe lesion in distraction caused by a predominantly ligamentous lesion, leading to displacement of the atlas on the axis [13].Vertebral displacements require reduction for neural decompression and stabilization. The most frequently used reduction mode is traction. This creates an unusual kind of stress in the craniocervical transition, called vertical distraction. Without ligamentous integrity, even a simple cranial traction can not be counterbalanced and may cause overdistraction among the vertebrae, with its consequences. Recently, traumatic vertical (longitudinal) dissociation between C1 and C2 has been described [8,15,19]. It is extremely difficult to predict which patient will develop this lesion after being subjected to the traction. Here, we describe the case of a patient with traumatic anterior atlantoaxial dislocation who developed a vertical dissociation after skull traction, studying its complications and how they are related to the skull traction. Case reportA 16-year-old female patient, E.C.S., who was run over by a vehicle on 5 May 1997, was immediately taken to the first aid clinic of Conjunto Hospitalar do Mandaqui, São Paulo, Brazil.Cardiorespiratory arrest was detected upon examination. She was submitted to resuscitation attempts. The patient was hemodynamically stabilized, and remained in a coma without opening her eyes and with no motor response, with a score of 3 on the Glasgow coma scale. She was submitted to computed axial tomography (CAT) of the skull, which permitted visualization of the high cervical column and identification of an anterior C1-C2 dislocation (scout view) (Fig. 1). The CAT scan showed a wide separation between the odontoid and the anterior C1 arch and a minimal bilateral displaced fracture of the anterior C1 arch (Fig. 2).Abstract Traumatic overdistraction between C1 and C2 may occur when all the ligaments connecting C2 to the skull are ruptured, and may be manifested when an attempt to reduce C1-C2 subluxation is made by means of traction. We describe here the case of a patient with traumatic anterior atlantoaxial dislocation, who developed atlantoaxial vertical dissociation after skull traction using a Gardner-Halo with lb 4.02 (1.5 kg) of weight. The identification of patients who are susceptible to this complication is difficult. In this case, it might have been prevented by avoiding spinal traction. The aim of this report was to show that vertical dissociation may occur in C1-C2 anterior dislocation submitted to spinal traction, and that other forms of reduction must be considered to treat these pathologies and avoid this potentially fatal complication.

show abstract

“…C1-C2 dissociation occurs with complete ligament lesion [1,5]. It is possible to speculate that the lesion occurred at the moment of the trauma, well before the traction.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Traumatic vertical atlantoaxial instability: the risk associated with skull traction. Case report and literature review

Botelho¹,

Palma

Abgussen

et al. 2000

European Spine Journal

View full text Add to dashboard Cite

show abstract

“…16 Davis et al reported five cases of disruption of the AO joint in postmortem radiographic studies of the head and spine among 50 consecutive deaths from acute trauma. 17 In the majority of the cases from these series, the injury was immediately fatal. Autopsy evaluation after such injuries has demonstrated direct mechanical injury of the lower brainstem and upper cervical spinal cord, usually consisting of transection of the cord, cord laceration with incomplete tear of the spinal cord, or spinal cord contusion.…”

Section: Incidence Mechanism and Consequences Of Atlantooccipital DImentioning

confidence: 99%

La prise en charge des voies aériennes supérieures a la suite d’une lésion de la colonne cervicale: que savons-nous de plus?

Crosby

2002

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Cervical spine injuries in patients with head injuries

Soicher

Δημητριάδης

1991

Journal of British Surgery

View full text Add to dashboard Cite

It is generally believed that significant head injury after a traffic accident or fall is associated with a high incidence of concurrent cervical spine injury. This study prospectively examined 260 victims of traffic accidents or falls with significant head injury. The incidence of associated cervical spinal injury was only 3.5 per cent. There was no association between the severity of head injury and the incidence of cervical spine injury. The risk of concurrent spinal injury in head injury patients is not higher than the reported risk in patients without head injury. Although care should be taken to protect the cervical spine in patients with head injury, the results of the present investigation show that the risk of cervical spine injury is much less than previously reported.

show abstract

The pathological findings in fatal craniospinal injuries

Cited by 125 publications

References 15 publications

Traumatic vertical atlantoaxial instability: the risk associated with skull traction. Case report and literature review

Traumatic vertical atlantoaxial instability: the risk associated with skull traction. Case report and literature review

La prise en charge des voies aériennes supérieures a la suite d’une lésion de la colonne cervicale: que savons-nous de plus?

Cervical spine injuries in patients with head injuries

Contact Info

Product

Resources

About