Three Cases of Traumatic Atlanto-Occipital Dislocation

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  • 外傷性環椎後頭関節脱臼の3例

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In this paper, the authors present 3 cases of traumatic atlanto-occipital dislocation (AOD). These cases were injured in traffic accident, and injury of mandible was identified. All cases were admitted in GCS score of 3 and primary brain stem injury was suspected. Lateral cervico-skull roentgenogram show increased Powers ratio (ratio of the basion-the posterior arch of the atlas and the opisthion of the occipital bone-the anterior arch of the atlas) and the widening of the retropharyngeal space. All patients were treated conservatively, and outcomes were death in 2 cases and persistent vegetative state in 1 case. In 2 cases, we performed magnetic resonance imaging (MRI), and in 1 case, a three-dimensional computed tomography (3D-CT) was performed. MRI clearly showed compression of cervicomedullary junction by displaced odontoid process. 3D-CT are useful for diagnosis of type of dislocation Reliabilities in making diagnosis with three-dimensional CT and MRI are discussed, with consideration of mechanisms of injury.

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