Ocular Manifestation of a Cervical Spine Injury: An Adult Case of Traumatic Atlantoaxial Rotatory Subluxation Manifesting with Nystagmus

Eghbal, Keyvan; Derakhshan, Nima; Haghighat, Ali

doi:10.1016/j.wneu.2017.02.064

Cited by 7 publications

(4 citation statements)

References 12 publications

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“…Treatment strategies for a case diagnosed early generally involve a closed reduction and immobilization with a halo-ring or cervical collar. For cases refractory to this treatment, as is common in chronic or recurrent cases with a delayed diagnosis, surgery may be indicated [2 , 5] .…”

Section: Discussionmentioning

confidence: 99%

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Atlantoaxial rotatory subluxation presenting as acute torticollis after mild trauma

Greenberg

Forgeon

Kurth

et al. 2020

Radiology Case Reports

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Atlantoaxial rotatory subluxation (AARS) is a rare outcome of trauma in adults. We present a case of a 38-year-old female who presented with neck pain and stiffness after a mild trauma. On exam the patient had a “cock-robin” position, comparable to acute torticollis. Computerized tomography demonstrated findings consistent with AARS. Reduction was performed in the emergency department and the patient had no further neurological sequelae. Recognition of AARS after trauma requires a high index of suspicion and early diagnosis is important to best patient outcomes.

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Section: Discussionmentioning

confidence: 99%

“…The most common presentation of AARS is a “cock-robin” position of the neck followed by a suboccipital headache [5] . This looks like torticollis, with the head tilted to 1 side, rotation to the contralateral side, and decreased range of neck motion [6] .…”

Section: Introductionmentioning

confidence: 99%

Atlantoaxial rotatory subluxation presenting as acute torticollis after mild trauma

Greenberg

Forgeon

Kurth

et al. 2020

Radiology Case Reports

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“…The typical clinical presentation includes cervical pain with torticollis and contralateral neck bending, known as Cock-Robin position [ 8 , 12 , 14 ]. Although some atypical accompanying clinical feature has also been reported [ 5 ]. Prompt diagnosis should be made on the basis of clinical presentations combined with appropriate imaging modalities such as CT-scan and MRI.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Adult Traumatic Atlantoaxial Rotatory Subluxation with Unilateral Locked Facet; Case Report and Literature Review

Eghbal

Rakhsha

Saffarrian

et al. 2018

BEAT

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Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck pain and torticollis after a car turn- over. There was C1-C2 rotatory subluxation with left side locked facet and C1 rotation about 40 degrees relative to C2 on computed tomography without evident of ligamentous injury in magnetic resonance imaging (MRI). However, during the first 48 hours, two tries of close reduction using Gardner cervical traction under fluoroscopy were failed. Thus, the patient underwent open reduction of the subluxation and atlantoaxial fixation (Harm’s technique) with subsequent relief of pain and torticollis. This a rare case of traumatic AARS type A with unilateral locked facet joint in an adult patient which needed surgical manipulation for reduction. The management of the AARS in adults should be individualized in each patient.

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“…Torticollis is frequently also experienced; this is a head tilt toward the ipsilateral side with chin rotation toward the contralateral side of the affected region 3. In addition to this, rare symptoms such as nystagmus and loss of vision can also be observed 4. The causes of AARS can be divided into traumatic and non-traumatic.…”

Section: Introductionmentioning

confidence: 99%

A missed traumatic atlanto-axial rotatory subluxation in an adult patient: case report

Barimani¹,

Fairag²,

Abduljabbar³

et al. 2019

OAEM

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BackgroundTraumatic atlanto-axial rotatory subluxation (AARS) in an adult is a rare condition, which if left untreated can be fatal. In addition to this, many symptoms experienced such as neck pain and stiffness are non-specific which often leads to misdiagnosis, thus delaying definitive treatment. AARS can be divided into traumatic and non-traumatic causes with the latter generally encompassing congenital cervical spine abnormalities.Case presentationWe present a case of a 66-year-old female with traumatic rotatory AARS, which was initially misdiagnosed in the emergency department. This patient was subsequently recalled to the hospital when the misdiagnosis was spotted the following day from imaging results. The patient was initially managed conservatively as an inpatient using head halter cervical traction which proved to give good clinical reduction allowing discharge with Miami J upon ambulation. Upon follow up the patient was experiencing continuous pain but remained neurovascularly intact. She thus opted for definitive management with C1–C2 stabilization with an open reduction and internal fixation.ConclusionThis case demonstrates the importance of having a high index of suspicion to diagnose AARS in cervical spine trauma presenting to the emergency department, until exclusion can be made using imaging and clinical examination.

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Ocular Manifestation of a Cervical Spine Injury: An Adult Case of Traumatic Atlantoaxial Rotatory Subluxation Manifesting with Nystagmus

Cited by 7 publications

References 12 publications

Atlantoaxial rotatory subluxation presenting as acute torticollis after mild trauma

Atlantoaxial rotatory subluxation presenting as acute torticollis after mild trauma

Surgical Management of Adult Traumatic Atlantoaxial Rotatory Subluxation with Unilateral Locked Facet; Case Report and Literature Review

A missed traumatic atlanto-axial rotatory subluxation in an adult patient: case report

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