Atlanto-occipital dissociation: Difference between revisions
(mortality with reference) |
No edit summary |
||
| Line 5: | Line 5: | ||
==Clinical Features== | ==Clinical Features== | ||
*Often associated | *Often associated with brain injury, which predicts mortality<ref>Mendenhall, S. K., Sivaganesan, A., Mistry, A., Sivasubramaniam, P., McGirt, M. J. and Devin, C. J. (2015) ‘Traumatic atlantooccipital dislocation: Comprehensive assessment of mortality, neurologic improvement, and patient-reported outcomes at a level 1 trauma center over 15 years’, The Spine Journal, 15(11), pp. 2385–2395</ref> | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Cervical spine injuries}} | {{Cervical spine injuries}} | ||
== | ==Diagnosis== | ||
[[File:Atlanto-occipital Dissociation.jpeg|thumbnail|Atlanto-occipital Dissociation]] | [[File:Atlanto-occipital Dissociation.jpeg|thumbnail|Atlanto-occipital Dissociation]] | ||
*Evaluate with the Powers ratio | *Evaluate with the Powers ratio | ||
| Line 37: | Line 37: | ||
==External Links== | ==External Links== | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Trauma]] | [[Category:Trauma]] | ||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revision as of 12:25, 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 with brain injury, which predicts mortality[1]
Differential Diagnosis
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Diagnosis
- 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 [2]
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
References
- ↑ Mendenhall, S. K., Sivaganesan, A., Mistry, A., Sivasubramaniam, P., McGirt, M. J. and Devin, C. J. (2015) ‘Traumatic atlantooccipital dislocation: Comprehensive assessment of mortality, neurologic improvement, and patient-reported outcomes at a level 1 trauma center over 15 years’, The Spine Journal, 15(11), pp. 2385–2395
- ↑ 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