Occult Cranial Cervical Dislocation: A Case Report and Brief Literature Review

Autor: Joshua B. Shatsky, Timothy B. Alton, Carlo Bellabarba, Richard J. Bransford
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Case Reports in Orthopedics, Vol 2016 (2016)
Druh dokumentu: article
ISSN: 2090-6749
2090-6757
DOI: 10.1155/2016/4930285
Popis: Study Design. Retrospective case report and review. Objective. Cranial cervical dislocation (CCD) is commonly a devastating injury. Delay in diagnosis has been found to lead to worse outcomes. Our purpose is to describe a rare case of occult cranial cervical dislocation (CCD) and use it to highlight key clinical and radiographic findings to ensure expedited diagnosis and proper management avoiding delays and subsequent neurologic deterioration. Method. Case report with literature review. Results. We describe a unique case of occult cranial cervical dislocation where initial imaging of the cervical spine failed to illustrate displacement of the occipital-cervical (O-C1) articulation or C1-C2 articulation. Careful evaluation of subtle radiographic clues suggested a more severe injury than initial review. Additional imaging was obtained due to these subtle clues confirming true cranial cervical dislocation allowing subsequent treatment with no neurologic sequelae. Conclusion. A high index of suspicion of CCD may prevent injury in select patients who present without gross cord compromise. Careful consideration of associated fractures, soft tissue injuries, and mechanism of injury are essential clues to the correct diagnosis and management of injuries to the craniocervical junction (CCJ).
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