Disruption of stabilizing ligaments between occiput and C1 ± between C1 and C2
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Relevant Anatomy
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Chang DG et al: Traumatic atlanto-occipital dislocation: analysis of 15 survival cases with emphasis on associated upper cervical spine injuries. Spine (Phila Pa 1976). 45(13):884-94, 2020
Martinez-Del-Campo E et al: Computed tomography parameters for atlantooccipital dislocation in adult patients: the occipital condyle-C1 interval. J Neurosurg Spine. 24(4):535-45, 2016
Theodore N et al: The diagnosis and management of traumatic atlanto-occipital dislocation injuries. Neurosurgery. 72 Suppl 2():114-26, 2013
Chaput CD et al: Defining and detecting missed ligamentous injuries of the occipitocervical complex. Spine (Phila Pa 1976). 36(9):709-14, 2011
Chaput CD et al: Survival of atlanto-occipital dissociation correlates with atlanto-occipital distraction, injury severity score, and neurologic status. J Trauma. 71(2):393-5, 2011
Bisson E et al: Combined occipital-cervical and atlantoaxial disassociation without neurologic injury: case report and review of the literature. Spine (Phila Pa 1976). 35(8):E316-21, 2010
Cooper Z et al: Identifying survivors with traumatic craniocervical dissociation: a retrospective study. J Surg Res. 160(1):3-8, 2010
Chang W et al: Diagnostic determinants of craniocervical distraction injury in adults. AJR Am J Roentgenol. 192(1):52-8, 2009
Gutiérrez-González R et al: Retropharyngeal pseudomeningocele formation as a traumatic atlanto-occipital dislocation complication: case report and review. Eur Spine J. 17 Suppl 2:S253-6, 2008
Horn EM et al: Survivors of occipitoatlantal dislocation injuries: imaging and clinical correlates. J Neurosurg Spine. 6(2):113-20, 2007
Pang D et al: Atlanto-occipital dislocation--part 2: The clinical use of (occipital) condyle-C1 interval, comparison with other diagnostic methods, and the manifestation, management, and outcome of atlanto-occipital dislocation in children. Neurosurgery. 61(5):995-1015; discussion 1015, 2007
Rojas CA et al: Reassessment of the craniocervical junction: normal values on CT. AJNR Am J Neuroradiol. 28(9):1819-23, 2007
Hanson JA et al: Radiologic and clinical spectrum of occipital condyle fractures: retrospective review of 107 consecutive fractures in 95 patients. AJR Am J Roentgenol. 178(5):1261-8, 2002
Chaljub G et al: Traumatic atlanto-occipital dislocation: MRI and CT. Neuroradiology. 43(1):41-4, 2001
Saeheng S et al: Traumatic occipitoatlantal dislocation. Surg Neurol. 55(1):35-40; discussion 40, 2001
Harris JH Jr et al: Radiologic diagnosis of traumatic occipitovertebral dissociation: 2. Comparison of three methods of detecting occipitovertebral relationships on lateral radiographs of supine subjects. AJR Am J Roentgenol. 162(4):887-92, 1994
Dickman CA et al: Traumatic occipitoatlantal dislocations. J Spinal Disord. 6(4):300-13, 1993
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Atlantooccipital dislocation (AOD)
Synonyms
Craniocervical dissociation
Occipitoatlantal dislocation
Definitions
Disruption of stabilizing ligaments between occiput and C1 ± between C1 and C2
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Relevant Anatomy
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Chang DG et al: Traumatic atlanto-occipital dislocation: analysis of 15 survival cases with emphasis on associated upper cervical spine injuries. Spine (Phila Pa 1976). 45(13):884-94, 2020
Martinez-Del-Campo E et al: Computed tomography parameters for atlantooccipital dislocation in adult patients: the occipital condyle-C1 interval. J Neurosurg Spine. 24(4):535-45, 2016
Theodore N et al: The diagnosis and management of traumatic atlanto-occipital dislocation injuries. Neurosurgery. 72 Suppl 2():114-26, 2013
Chaput CD et al: Defining and detecting missed ligamentous injuries of the occipitocervical complex. Spine (Phila Pa 1976). 36(9):709-14, 2011
Chaput CD et al: Survival of atlanto-occipital dissociation correlates with atlanto-occipital distraction, injury severity score, and neurologic status. J Trauma. 71(2):393-5, 2011
Bisson E et al: Combined occipital-cervical and atlantoaxial disassociation without neurologic injury: case report and review of the literature. Spine (Phila Pa 1976). 35(8):E316-21, 2010
Cooper Z et al: Identifying survivors with traumatic craniocervical dissociation: a retrospective study. J Surg Res. 160(1):3-8, 2010
Chang W et al: Diagnostic determinants of craniocervical distraction injury in adults. AJR Am J Roentgenol. 192(1):52-8, 2009
Gutiérrez-González R et al: Retropharyngeal pseudomeningocele formation as a traumatic atlanto-occipital dislocation complication: case report and review. Eur Spine J. 17 Suppl 2:S253-6, 2008
Horn EM et al: Survivors of occipitoatlantal dislocation injuries: imaging and clinical correlates. J Neurosurg Spine. 6(2):113-20, 2007
Pang D et al: Atlanto-occipital dislocation--part 2: The clinical use of (occipital) condyle-C1 interval, comparison with other diagnostic methods, and the manifestation, management, and outcome of atlanto-occipital dislocation in children. Neurosurgery. 61(5):995-1015; discussion 1015, 2007
Rojas CA et al: Reassessment of the craniocervical junction: normal values on CT. AJNR Am J Neuroradiol. 28(9):1819-23, 2007
Hanson JA et al: Radiologic and clinical spectrum of occipital condyle fractures: retrospective review of 107 consecutive fractures in 95 patients. AJR Am J Roentgenol. 178(5):1261-8, 2002
Chaljub G et al: Traumatic atlanto-occipital dislocation: MRI and CT. Neuroradiology. 43(1):41-4, 2001
Saeheng S et al: Traumatic occipitoatlantal dislocation. Surg Neurol. 55(1):35-40; discussion 40, 2001
Harris JH Jr et al: Radiologic diagnosis of traumatic occipitovertebral dissociation: 2. Comparison of three methods of detecting occipitovertebral relationships on lateral radiographs of supine subjects. AJR Am J Roentgenol. 162(4):887-92, 1994
Dickman CA et al: Traumatic occipitoatlantal dislocations. J Spinal Disord. 6(4):300-13, 1993
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