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[Craniocervical dissociation]
Kjell Alexander Thunes Akre1, Clemens Weber1, David Andreas Thomas Werner1
1Nevrokirurgisk avdeling, Stavanger universitetssjukehus.
Summary
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:
- 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.