Atlanto-occipital dislocation

Reported is the case of a 29-year-old woman who sustained an atlanto-occipital dislocation (AOD). This patient survived the initial resuscitation to expire some 72 hours later. Survival of patients with AOD is being reported with increasing frequency and with good neurologic recovery in many cases. Emergency physicians should be aware of this injury and the methods of initial evaluation and stabilization in order to maximize the potential for patients with these serious injuries. Radiographic features of AOD are outlined and the potential hazards of longitudinal traction are emphasized.