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[Traumatic atlanto-occipital dislocation with minimal neurologic deficits]
J J van der Meulen1, J D Meeuwis, M Sluzewski
1Afd. Chirurgie, St. Elisabeth Ziekenhuis, Postbus 90.151, 5000 LC Tilburg.
Nederlands Tijdschrift Voor Geneeskunde
|January 5, 2002
Summary
Atlanto-occipital dislocation, a rare injury, occurred in a young woman after a scooter accident. Prompt repositioning under fluoroscopic control led to recovery, though mild arm weakness persisted.
Area of Science:
- Traumatology
- Radiology
- Neurosurgery
Background:
- Atlanto-occipital dislocation (AOD) is a severe injury involving the uppermost articulation of the spine.
- AOD is often associated with significant neurological deficits or mortality.
- This case highlights a rare presentation of AOD without profound neurological compromise.
Observation:
- A 21-year-old female sustained mild neck pain post-scooter accident.
- Initial cervical radiographs suggested lateralization of the dens axis relative to the foramen magnum.
- CT imaging with multiplanar reconstruction confirmed atlanto-occipital dislocation.
Findings:
- The atlanto-occipital dislocation was successfully reduced under fluoroscopic guidance.
- The patient experienced an uneventful recovery post-reduction.
- A residual mild deficit in left arm strength was noted.
Implications:
- This case underscores the possibility of AOD occurring with minimal neurological deficits.
- It emphasizes the critical role of advanced imaging like CT in diagnosing subtle but severe spinal injuries.
- Early diagnosis and intervention are crucial for favorable outcomes in traumatic spinal injuries.