Unrecognized traumatic atlanto-occipital dislocation

Henry, Michael; Angelastro, David B; Gillen, James

doi:10.1016/s0735-6757(98)90142-5

Cited by 16 publications

(10 citation statements)

References 13 publications

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“…24,25 Rupture of the alar ligaments and the tectorial membrane, as well as the occipito-atlantal joint capsules and membranes, lead to severe C0-C1 instability in a vertical, anterior or posterior direction. 26,27 Diagnosis is usually established from plain lateral cervical radiographs in most cases, 28,29 but CT scan with sagittal reconstruction or MRI may be required when diagnosis is questionable. 9,30 In the case of our patient, the AOD was clearly evident in the plain cervical spine radiograph (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

“…5,8 Respiratory insufficiency and cardiac arrhythmia occur frequently and, together with respiratory distress, may be secondary to brainstem compression, or lower cranial nerve palsies causing airway obstruction, in addition to diaphragmatic paralysis. 29,33 Neck swelling can also be an important sign of AOD in a coma patient. 34,35 Hypertension can occur owing to bilateral glossopharyngeal nerve lesions, 36 whereas complete cord transection can cause hypotension.…”

Section: Discussionmentioning

confidence: 99%

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Complete medulla/cervical spinal cord transection after atlanto-occipital dislocation: An extraordinary case

2006

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Study design: Case report. Summary of background data: Traumatic atlanto-occipital dislocation (AOD) with a complete medulla/spinal cord transection is rare and believed to be fatal owing to the high level of the spinal cord injury. Clinical outcome is poor. Consequently, relatively few case reports of adult patients surviving this injury appear in the literature. Objectives and result: We present the case of a 20-year-old male, who sustained an AOD with a complete medulla/spinal cord transection in a motorcycle accident to discuss the possibility of long-term survival with this condition. The patient underwent occipito-cervical stabilization. With an Injury Severity Score of 75, by definition unsurvivable, the patient is 16 months after the injury, ventilated and fully dependent for all care. Conclusion: Long-term survival following AOD with a complete medulla/spinal cord transection is possible if immediate resuscitation at the scene is available. Nevertheless, it remains questionable whether or not a patient with such a devastating injury and without any prospect of functional recovery should be kept alive under all circumstances.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Complete medulla/cervical spinal cord transection after atlanto-occipital dislocation: An extraordinary case

2006

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“…Due to an increasing efficiency of onscene resuscitation and modern diagnostics, the surgeon should expect being faced to diagnose and treat these seldom injuries more often [1,2,11,17]. In most of the cases patients as driver or passerby suffered AOD following a high-velocity injury as result of motor vehicle accidents [1,3,8,14,[16][17][18][25][26][27][28]. As a result of a maximum impact to the upper cervical spine one also has to expect further CSI associated with AOD.…”

Section: Epidemiologymentioning

confidence: 99%

“…This might divert suspicion from the AOD and other CSI [30,33]. Many authors report on delayed or neglected diagnosis of AOD, which have been detected later on after neurologic deterioration or in secondary survey or autopsy [2,3,8,26,27,30,34]. Neurological deteriotation was observed with an incidence up to 36% [27,34].…”

Section: Epidemiologymentioning

confidence: 99%

Traumatic Atlantooccipital Dislocation

et al. 2006

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Traumatic atlantooccipital dislocation (AOD) is a severe injury which functionally separates the head from the spine. Neurological compromise or death is the common sequela. We report on a survivor after AOD, who came back to sportive activities after operative stabilization C0-2. Actually, due to the lack of large single institution series, there are no clearly recommended guidelines concerning diagnostics and treatment of AOD. Overlooking a critical review of literature, the inferences of our case are illustrated and diagnostic as well as operative treatment concepts are discussed.

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“…3,4 A range of injuries has been reported as a result of the deployment of the air bag and the injuries vary from minor to fatalities. The injuries range from bilateral smith fracture, 5 colles fracture, 6 burns to face and hands, 3,4,7-10 otologic injuries, 11,12 eye injuries, [13][14][15][16] maxillofacial fractures, 17 facial paresis, 18 basilar skull fracture, 19 with transection of the internal carotid artery, 20 atlanto-occipital dislocation, [21][22][23] and spinal cord injuries. 24,25 The severity of the injury relates directly to the proximity of the driver to the steering column and the force and the direction of the impact of the airbag.…”

Section: Airbag Mechanismsmentioning

confidence: 99%

Temporomandibular joint pain following airbag deployment on the face: a case report

Ali

2004

Br Dent J

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Varieties of injuries have been reported as a result of the deployment of the airbag/s following road traffic accidents. The purpose of this case-report is to present a physiotherapist's perspective of a patient who was diagnosed as having temporomandibular pain and dysfunction following the deployment of the airbag on the face and its implications for the dental profession. The patient was assessed using a modified Maitland assessment procedure to establish the diagnosis and the treatment consisted of Maitland mobilisation techniques, pulsed short wave diathermy and ultrasound as and when indicated directed to the upper cervical spine. The outcome of this case-report suggests that the temporomandibular symptoms presented by this patient were of cervical origin. Therefore, it is suggested that the cervical spine should be routinely examined in patients presenting with temporomandibular pain and dysfunction following trauma and early referral to physiotherapy may facilitate early recovery.

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Unrecognized traumatic atlanto-occipital dislocation

Cited by 16 publications

References 13 publications

Complete medulla/cervical spinal cord transection after atlanto-occipital dislocation: An extraordinary case

Complete medulla/cervical spinal cord transection after atlanto-occipital dislocation: An extraordinary case

Traumatic Atlantooccipital Dislocation

Temporomandibular joint pain following airbag deployment on the face: a case report

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