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Atlantooccipital Dislocation
Jeffrey S. Ross, MD
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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

                                            1. Theodore N et al: The diagnosis and management of traumatic atlanto-occipital dislocation injuries. Neurosurgery. 72 Suppl 2():114-26, 2013
                                            2. Chaput CD et al: Defining and detecting missed ligamentous injuries of the occipitocervical complex. Spine (Phila Pa 1976). 36(9):709-14, 2011
                                            3. 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
                                            4. 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
                                            5. Cooper Z et al: Identifying survivors with traumatic craniocervical dissociation: a retrospective study. J Surg Res. 160(1):3-8, 2010
                                            6. Chang W et al: Diagnostic determinants of craniocervical distraction injury in adults. AJR Am J Roentgenol. 192(1):52-8, 2009
                                            7. 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
                                            8. Horn EM et al: Survivors of occipitoatlantal dislocation injuries: imaging and clinical correlates. J Neurosurg Spine. 6(2):113-20, 2007
                                            9. 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
                                            10. Rojas CA et al: Reassessment of the craniocervical junction: normal values on CT. AJNR Am J Neuroradiol. 28(9):1819-23, 2007
                                            11. 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
                                            12. Chaljub G et al: Traumatic atlanto-occipital dislocation: MRI and CT. Neuroradiology. 43(1):41-4, 2001
                                            13. Saeheng S et al: Traumatic occipitoatlantal dislocation. Surg Neurol. 55(1):35-40; discussion 40, 2001
                                            14. 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
                                            15. 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

                                                                                      1. Theodore N et al: The diagnosis and management of traumatic atlanto-occipital dislocation injuries. Neurosurgery. 72 Suppl 2():114-26, 2013
                                                                                      2. Chaput CD et al: Defining and detecting missed ligamentous injuries of the occipitocervical complex. Spine (Phila Pa 1976). 36(9):709-14, 2011
                                                                                      3. 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
                                                                                      4. 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
                                                                                      5. Cooper Z et al: Identifying survivors with traumatic craniocervical dissociation: a retrospective study. J Surg Res. 160(1):3-8, 2010
                                                                                      6. Chang W et al: Diagnostic determinants of craniocervical distraction injury in adults. AJR Am J Roentgenol. 192(1):52-8, 2009
                                                                                      7. 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
                                                                                      8. Horn EM et al: Survivors of occipitoatlantal dislocation injuries: imaging and clinical correlates. J Neurosurg Spine. 6(2):113-20, 2007
                                                                                      9. 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
                                                                                      10. Rojas CA et al: Reassessment of the craniocervical junction: normal values on CT. AJNR Am J Neuroradiol. 28(9):1819-23, 2007
                                                                                      11. 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
                                                                                      12. Chaljub G et al: Traumatic atlanto-occipital dislocation: MRI and CT. Neuroradiology. 43(1):41-4, 2001
                                                                                      13. Saeheng S et al: Traumatic occipitoatlantal dislocation. Surg Neurol. 55(1):35-40; discussion 40, 2001
                                                                                      14. 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
                                                                                      15. Dickman CA et al: Traumatic occipitoatlantal dislocations. J Spinal Disord. 6(4):300-13, 1993