Atlanto-occipital dissociation

Case contributed by Dr Andrew Dixon


Motorbike accident. GCS 3

Patient Data

Age: 30
Gender: Male

Trauma room horizontal beam x-ray showing marked non-survivable atlanto-occipital dissociation with several centimeters of seperation between the lateral masses of C1 and the occipital condyles. Marked prevertebral soft-tissue thickening is also seen displacing the ETT anteriorly. 

Case Discussion

The cervical spine radiograph has little roll in the imaging of the cervical spine in adult major trauma as CT is the investigation of choice, however clinical suspicion of non-survivable atlanto-occipital dissociation in this case promoted the trauma team to perform an x-ray in the trauma bay. By quickly confirming a non-survivable injury, a superfluous trauma CT pan scan was able to be avoided. 

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Case information

rID: 45395
Published: 24th May 2016
Last edited: 14th Aug 2019
System: Trauma
Inclusion in quiz mode: Included

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