A Case of Asymptomatic Occipital Condyle Fracture with Incomplete Occipitocervical Dislocation: How Did It Happen?

World Neurosurg. 2018 Jan:109:403-408. doi: 10.1016/j.wneu.2017.10.082. Epub 2017 Nov 14.

Abstract

Background: Atlanto-occipital dislocation (AOD) is a lesion rarely observed in a trauma center, because of high mortality in the preclinical phase. The number of AOD survivors is increasing thanks to the improvement in prehospital resuscitation.

Case description: Our goal is to describe a case of incomplete atlanto-occipital dislocation presented without any neurologic, cardiorespiratory, or metabolic problems, which remained constant even after surgical treatment. Our purpose is also to discuss treatment approaches to minimize subsequent neurologic deficits.

Conclusions: We recommend a rapid immobilization with spine table and cervical collar, the consensual stabilization of hemodynamic and respiratory parameters, and a successive prompt occipitocervical stabilization. C2 should be included in the stabilization because of the ligamentous conformation of craniocervical joint.

Keywords: Atlanto-occipital; Cervical; Dislocation; Fracture; Occipitocervical.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Atlanto-Occipital Joint / diagnostic imaging
  • Atlanto-Occipital Joint / injuries*
  • Atlanto-Occipital Joint / surgery
  • Bone Screws
  • Bone Wires
  • Follow-Up Studies
  • Fracture Dislocation / diagnostic imaging
  • Fracture Dislocation / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Occipital Bone / diagnostic imaging
  • Occipital Bone / injuries*
  • Occipital Bone / surgery
  • Postoperative Complications / diagnostic imaging
  • Skull Fractures / diagnostic imaging
  • Skull Fractures / surgery*
  • Spinal Fusion / methods
  • Tomography, X-Ray Computed