Atlanto-occipital dissociation: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Often associated w/ brain injury | *Often associated w/ brain injury | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Workup== | ==Workup== | ||
[[File:Atlanto-occipital Dissociation.jpeg|thumbnail|Atlanto-occipital Dissociation]] | [[File:Atlanto-occipital Dissociation.jpeg|thumbnail|Atlanto-occipital Dissociation]] | ||
*Evaluate with the Powers ratio | |||
**Ratio of BC:OA > 1 suggests anterior subluxation | |||
**BC = distance between basion and midpoint of C2 post laminar line | |||
**OA = Distance between opisthion and ant arch of C2 | |||
==Management== | ==Management== | ||
Revision as of 02:18, 2 January 2015
Background
- Is an unstable spine injury
- Down syndome predisposes to atlanto-occipital dislocation
Clinical Features
- Often associated w/ brain injury
Differential Diagnosis
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Workup
- Evaluate with the Powers ratio
- Ratio of BC:OA > 1 suggests anterior subluxation
- BC = distance between basion and midpoint of C2 post laminar line
- OA = Distance between opisthion and ant arch of C2
Management
Prehospital Immobilization
See the NAEMSP National Guidelines for Spinal Immobilization
Hospital
- C-collar
- Consult ortho or spine as needed
Disposition
- Admit