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[Craniocervical dissociation].

Kjell Alexander Thunes Akre1, Clemens Weber1, David Andreas Thomas Werner1

  • 1Nevrokirurgisk avdeling, Stavanger universitetssjukehus.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|August 22, 2025
PubMed
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Craniocervical dissociation (CCD) is a severe, high-energy trauma. Prompt diagnosis via imaging and surgical fusion (C0-C4) can lead to favorable outcomes in patients with this potentially fatal injury.

Area of Science:

  • Traumatology
  • Neurosurgery
  • Orthopedic Surgery

Background:

  • Craniocervical dissociation (CCD) is a rare, life-threatening injury from high-energy trauma.
  • Early recognition and management are crucial for reducing mortality and complications.

Purpose of the Study:

  • To present a case of severe craniocervical dissociation following blunt trauma.
  • To emphasize the importance of timely diagnosis and surgical intervention.

Main Methods:

  • A case report of a pedestrian struck by a bus, presenting with severe neck pain.
  • Diagnostic imaging included CT and MRI.
  • Surgical management involved posterior occipitocervical fusion (C0-C4).

Main Results:

Related Experiment Videos

  • CT revealed occipital condyle fracture, atlanto-occipital dislocation, and atlantoaxial widening (Traynelis type II).
  • MRI showed prevertebral swelling and alar ligament disruption without spinal cord injury.
  • Postoperative imaging confirmed good reduction after C0-C4 fusion.
  • Conclusions:

    • This case underscores the necessity of early imaging for identifying unstable craniocervical injuries.
    • Prompt surgical treatment can achieve favorable functional outcomes even in severe trauma cases.