Painful torticollis following adenotonsillectomy: a cardinal sign of atlantoaxial subluxation
| Autor: | Arif Rashid, Raj Lakhani, Philipa Tostevin, Benjamin John Miller |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Joint Dislocations Physical examination Adenoidectomy 03 medical and health sciences 0302 clinical medicine Throat otorhinolaryngologic diseases medicine Humans Child 030223 otorhinolaryngology Torticollis Nose Tonsillectomy Pain Postoperative medicine.diagnostic_test business.industry General Medicine Emergency department medicine.disease Reminder of Important Clinical Lesson Surgery medicine.anatomical_structure Atlanto-Axial Joint Ligament Neurosurgery Tomography X-Ray Computed business Complication 030217 neurology & neurosurgery |
| Zdroj: | BMJ Case Reports. :bcr-2017 |
| ISSN: | 1757-790X |
| DOI: | 10.1136/bcr-2017-223567 |
| Popis: | An 11-year-old boy with a history of autism spectrum disorder attended the emergency department with his mother 8 days after an adenotonsillectomy reporting postoperative bleeding. Detailed physical examination revealed no active bleeding, but a rigid neck posture was noted. A head and neck CT scan demonstrated unilateral rotatory atlantoaxial subluxation and possible damage to the anterior spinal ligament. He was reviewed by neurosurgeons who performed manipulation under anaesthetic and successfully realigned the occipital cervical tract. Non-traumatic atlantoaxial subluxation (Grisel's syndrome) is a rare but serious complication of routine ear, nose and throat (ENT) procedures. An awareness of this complication among paediatricians, otolaryngologists and emergency physicians, and a high index of suspicion in any patient presenting with torticollis following ENT surgery is essential in preventing significant neurological morbidity. |
| Databáze: | OpenAIRE |
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