Surviving atlanto‐occipital dislocation

Abstract

Traumatic atlanto-occipital dislocation carries a significant mortality and morbidity. We present the clinical and radiological features of a case of traumatic skeletal and central nervous system disunion. Thanks to a combination of early resuscitation and luck, the patient survived an improbably severe injury to leave hospital and enjoy a degree of independent life. Such severe injuries are usually fatal and the literature on such extensive cervical disruption is often confined to postmortem evidence.

Traumatic Atlanto-Occipital Dislocation: A Case Report

“…Most patients with an atlanto-occipital dislocation are either immediately dead or survive only for few hours, 6,7 although survival cases have been reported recently. [9][10][11][12][13][14][15][16] This injury is mainly ligamentous and occurs as a consequence of rapid deceleration of the trunk in relation to the head. Owing to improved prehospital care, rapid rescue, and shorter transportation time, the number of patients surviving atlantooccipital dislocation is increasing.…”

Survival of Atlanto-Occipital Dissociation Correlates With Atlanto-Occipital Distraction, Injury Severity Score, and Neurologic Status

“…1 AOD is known to have a significant mortality rate, 2 and it is estimated that ϳ20% of all fatal traffic collisions involve injury to the upper cervical spine. 1 However, improvement in prehospital care and the use of universal spinal precautions have made AODs an increasingly survivable condition.…”

Prognostic factors in traumatic atlanto-occipital dislocation

“…Patients suffering from AOD may have signs of SCI (complete or incomplete), cranial nerve palsy, and brainstem compression [7,27]. Cardiopulmonary instability and respiratory arrest at the scene of the accident are common signs of AOD [8,11,15,22]. High mortality associated with this type of injury is probably due to direct impact on the medulla, which may lead to cardiac arrhythmia, blood pressure instability, and respiratory arrest [8,28].…”

“…Traumatic AOD is a rare but devastating injury [1,3,11]. Fatality rates of AOD in MVA incidents are reported to be as high as 20-35% [5].…”