Atlanto-occipital dissociation: Difference between revisions
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**BC = distance between basion and midpoint of C2 post laminar line | **BC = distance between basion and midpoint of C2 post laminar line | ||
**OA = Distance between opisthion and ant arch of C2 | **OA = Distance between opisthion and ant arch of C2 | ||
*Basion to dens interval of > 10mm <ref>Riascos R, Bonfante E, Cotes C et-al. Imaging of Atlanto-Occipital and Atlantoaxial Traumatic Injuries: What the Radiologist Needs to Know. Radiographics. 2015;35</ref> | |||
==Management== | ==Management== | ||
Revision as of 03:46, 19 December 2015
Background
- Is an unstable spine injury
- Also referred to as internal decapitation
- Down syndome predisposes to atlanto-occipital dislocation
Clinical Features
- Often associated w/ brain injury
Differential Diagnosis
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Workup
- Evaluate with the Powers ratio
- Ratio of BC:OA > 1 suggests anterior subluxation
- BC = distance between basion and midpoint of C2 post laminar line
- OA = Distance between opisthion and ant arch of C2
- Basion to dens interval of > 10mm [1]
Management
Prehospital Immobilization
See the NAEMSP National Guidelines for Spinal Immobilization
Hospital
- C-collar
- Consult ortho or spine as needed
Disposition
- Admit
See Also
External Links
Sources
- ↑ Riascos R, Bonfante E, Cotes C et-al. Imaging of Atlanto-Occipital and Atlantoaxial Traumatic Injuries: What the Radiologist Needs to Know. Radiographics. 2015;35