単独後頭顆骨折の1症例

DOI
  • 相川 光広
    千葉県救急医療センター神経系治療科（内科系）
  • 古口 德雄
    千葉県救急医療センター神経系治療科（内科系）

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  • A case of isolated occipital condyle fracture

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<p>A 46-year-old man fallen down on the floor after the faint signs was brought to our hospital. On admission he complained of chest discomfort and left neck pain No deficits were noticed on complete neurologic examination. Electrocardiogram revealed ST segment depression in II III aVF. He was diagnosed with acute coronary syndrome, then performed primary percutaneous coronary intervention (PCI). After PCI, computed tomography scan (CT) of the cervical spine was performed. It revealed a displaced avulsion fracture of the left occipital condyle (Anderson and Montesano classification type III). No other fractures was present. Isolated occipital condyle fracture (OCF) was diagnosed. The stability of occipito-atlantal and atlanto-axial joint was maintained, so the fracture was managed conservatively.</p><p>An isolated OCF is considered extremely rare, but OCFs are may be often overlooked in both clinical and autopsy settings. According to the currently available medical literatures, CT scans are considered superior to conventional radiography for diagnosis of OCFs, especially isolated OCFs. A multiplanar reconstruction CT image is essential in diagnosing these fractures; coronal reconstructions together with axial scans are particularly helpful. Three-dimensional reconstruction did not prove essential in diagnosing these fractures. In any case, the diagnosis of OCF requires a high index of suspicion.</p>

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