Management of Traumatic Atlantooccipital Dissociation at a Level 1 Trauma Center: A Retrospective Case Series

Wathen, Connor; Ghenbot, Yohannes; Chauhan, Daksh; Schuster, James M.; Petrov, Dmitriy

doi:10.1016/j.wneu.2022.11.002

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…For example, a recent case series found that in patients with atlantooccipital dislocation, 73% had concomitant blunt cerebrovascular injury, 50% had TBI, and 60% had cardiac arrest before hospital arrival. 113 SPINAL CORD PERFUSION. Perfusion of the spinal cord is supported by a complex anastomotic network.…”

Section: Supportive Care and Mitigation Of Secondary Injurymentioning

confidence: 99%

“…These injuries often occur in the setting of high-energy trauma, and their clinical recognition may be obscured by the number and severity of other injuries. For example, a recent case series found that in patients with atlantooccipital dislocation, 73% had concomitant blunt cerebrovascular injury, 50% had TBI, and 60% had cardiac arrest before hospital arrival 113 …”

Section: Traumatic Spinal Cord Injurymentioning

confidence: 99%

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Traumatic Brain Injury and Traumatic Spinal Cord Injury

Podell,

Morris

2024

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVE This article reviews the mechanisms of primary traumatic injury to the brain and spinal cord, with an emphasis on grading severity, identifying surgical indications, anticipating complications, and managing secondary injury. LATEST DEVELOPMENTS Serum biomarkers have emerged for clinical decision making and prognosis after traumatic injury. Cortical spreading depolarization has been identified as a potentially modifiable mechanism of secondary injury after traumatic brain injury. Innovative methods to detect covert consciousness may inform prognosis and enrich future studies of coma recovery. The time-sensitive nature of spinal decompression is being elucidated. ESSENTIAL POINTS Proven management strategies for patients with severe neurotrauma in the intensive care unit include surgical decompression when appropriate, the optimization of perfusion, and the anticipation and treatment of complications. Despite validated models, predicting outcomes after traumatic brain injury remains challenging, requiring prognostic humility and a model of shared decision making with surrogate decision makers to establish care goals. Penetrating injuries, especially gunshot wounds, are often devastating and require public health and policy approaches that target prevention.

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Section: Supportive Care and Mitigation Of Secondary Injurymentioning

confidence: 99%

Section: Traumatic Spinal Cord Injurymentioning

confidence: 99%

Traumatic Brain Injury and Traumatic Spinal Cord Injury

Podell,

Morris

2024

CONTINUUM: Lifelong Learning in Neurology

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Atlanto-occipital Dissociation

Sheppard,

Savage,

Moore

2024

Clinical Spine Surgery

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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. In survivors, his injury is often missed or the diagnosis is often delayed. Mortality rates commonly reach beyond 60% when injury patterns go unrecognized. Approximately 50% of patients with AOD sustain blunt cerebrovascular injury and nearly 20% of patients present with traumatic brain injury (TBI) or stroke. This pathology was once considered uniformly fatal. However, over the last 20 years, significant advancements have been made both clinically and radiographically, to better identify and manage this injury pattern. Despite improvements in clinical comprehension and improved time to diagnosis, less than 75% of cases are currently recognized within 24 hours. Less than 40% of patients who suffer AOD are independent with functionality, without neurological impairment. This article reviews current literature regarding AOD in hopes to improve timing to diagnosis, subsequent prognosis, timing to fixation or stabilization, and postoperative recovery.

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Management of Traumatic Atlantooccipital Dissociation at a Level 1 Trauma Center: A Retrospective Case Series

Cited by 2 publications

References 13 publications

Traumatic Brain Injury and Traumatic Spinal Cord Injury

Traumatic Brain Injury and Traumatic Spinal Cord Injury

Atlanto-occipital Dissociation

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