Background: Traumatic atlanto-occipital dislocation (AOD) is a rare but often fatal injury. Consequently, long-term data regarding surviving patients have been limited. In particular, the occurrence of hydrocephalus is not well-documented.
Case Description: A 33-year-old male sustained AOD as a consequence of a motor vehicle collision. Although he did well initially after an occipitocervical fusion, 1 month after his operation, he exhibited signs of increased intracranial pressure (bilateral abducens nerve palsies, worsening headaches, and fatigue). He was found to have hydrocephalus, which was responsive to shunting.
Conclusion: Manifestations of hydrocephalus after AOD can be variable, ranging from interval ventricular dilatation to pseudomeningoceles and syringomyelia. In addition, the timing of presentation can be acute, requiring emergent external ventricular drainage, or delayed, requiring ongoing vigilance. Consequently, as more patients survive this once thought to be fatal injury, caution for hydrocephalus is stressed.
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http://dx.doi.org/10.4103/2152-7806.191076 | DOI Listing |
J Orthop Case Rep
December 2024
Department of Spine Surgery, Children Hospital Westmead, Sydney, Australia.
Introduction: Death is the most common outcome of longitudinal atlanto-occipital dissociation (L-AOD). Even though rare, survival is commonly seen in the pediatric population. This study reports a successful outcome of a pediatric patient with an L-AOD without neurodeficits, immobilized in a visor (head-neck-chest) orthosis.
View Article and Find Full Text PDFActa Neurochir Suppl
November 2024
Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.
The occipitocervical junction is formed by the foramen magnum (FM) and the adjacent anatomical structures of the C1 and C2 vertebrae. The FM is formed anteriorly by the basilar part of occipital bone. Anterolaterally, it borders the occipital condyles and hypoglossal canal as well as the jugular foramen.
View Article and Find Full Text PDFClin Spine Surg
November 2024
Department of Orthopaedic Surgery, Case Western Reserve University School of Medicine, Cleveland, OH.
Atlanto-occipital dissociation (AOD) is an extremely common injury but often fatal. In a systematic review from 2010, AODs were present in almost 20% of blunt trauma fatalities. It is an injury many patients do not survive; therefore, few are treated, even at high volume trauma centers.
View Article and Find Full Text PDFCureus
August 2024
Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.
Subluxation of the atlantooccipital joint in patients with underlying Down syndrome is an extremely rare orthopedic condition. The condition can pose life-threatening risks if not promptly diagnosed and treated in the early stage. Yet, there have been documented cases of survival following atlantooccipital subluxation or dislocation.
View Article and Find Full Text PDFObjective: Postconcussive symptom questionnaires (PCSQs) are often used in concussion patient assessment, yet there is a lack of knowledge as to whether symptom subtype prevalence is dependent on the mechanism of injury (MOI). These subtypes can be defined as cognitive, atlanto-occipital/cervical spine, autonomic, balance, low energy/fatigue/sleep, emotional changes, eyes, and somatic. Using an institutional PCSQ that quantitatively addressed these subtypes, this retrospective study aimed to provide insight into differences in subtype symptomatology between sports-related (SR) and non-sports-related (NSR) injuries.
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