link
Bookmarks
Craniocervical Junction Injuries
Luke L. Linscott, MD
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
0
2
4
0

KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Craniocervical junction (CCJ) injuries
            • Definitions

              • Traumatic injury to upper cervical region: Occiput to C2
                • Much more common in 1st decade than in older children & adults
            • Types of CCJ Injuries

              • Atlantooccipital dissociation (AOD)
                • (a.k.a. atlantooccipital dislocation; occipitocervical dissociation)
              • Atlantoaxial dissociation
                • (a.k.a. atlantoaxial dislocation)
              • Jefferson fracture (C1 ring)
              • Odontoid (C2) fracture
              • Hangman (C2) fracture
              • Atlantoaxial rotatory fixation
              • Spinal cord injury without radiographic abnormality

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nonvascular Interventions

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      Selected References

                                      1. Corcoran B et al: Application of normative occipital condyle-C1 interval measurements to detect atlanto-occipital injury in children. AJNR Am J Neuroradiol. 37(5):958-62, 2016
                                      2. Smith P et al: Normal development and measurements of the occipital condyle-C1 interval in children and young adults. AJNR Am J Neuroradiol. 37(5):952-7, 2016
                                      3. Dorney K et al: Outcomes of pediatric patients with persistent midline cervical spine tenderness and negative imaging result after trauma. J Trauma Acute Care Surg. 79(5):822-7, 2015
                                      4. Hannon M et al: Pediatric cervical spine injury evaluation after blunt trauma: a clinical decision analysis. Ann Emerg Med. 65(3):239-47, 2015
                                      5. Vachhrajani S et al: Estimation of normal computed tomography measurements for the upper cervical spine in the pediatric age group. J Neurosurg Pediatr. 14(4):425-33, 2014
                                      6. Astur N et al: Traumatic atlanto-occipital dislocation in children: evaluation, treatment, and outcomes. J Bone Joint Surg Am. 95(24):e194(1-8), 2013
                                      7. Gargas J et al: An analysis of cervical spine magnetic resonance imaging findings after normal computed tomographic imaging findings in pediatric trauma patients: ten-year experience of a level I pediatric trauma center. J Trauma Acute Care Surg. 74(4):1102-7, 2013
                                      8. Henry M et al: A retrospective comparison of CT and MRI in detecting pediatric cervical spine injury. Childs Nerv Syst. 29(8):1333-8, 2013
                                      9. Booth TN: Cervical spine evaluation in pediatric trauma. AJR Am J Roentgenol. 198(5):W417-25, 2012
                                      10. Chung S et al: Trauma association of Canada Pediatric Subcommittee National Pediatric Cervical Spine Evaluation Pathway: consensus guidelines. J Trauma. 70(4):873-84, 2011
                                      11. Junewick JJ: Pediatric craniocervical junction injuries. AJR Am J Roentgenol. 196(5):1003-10, 2011
                                      12. Leonard JC et al: Factors associated with cervical spine injury in children after blunt trauma. Ann Emerg Med. 58(2):145-55, 2011
                                      13. Junewick JJ: Cervical spine injuries in pediatrics: are children small adults or not? Pediatr Radiol. 40(4):493-8, 2010
                                      14. Bertozzi JC et al: Evaluation of the pediatric craniocervical junction on MDCT. AJR Am J Roentgenol. 192(1):26-31, 2009
                                      15. Junewick JJ et al: Occult injury of the pediatric craniocervical junction. Emerg Radiol. 16(6):483-8, 2009
                                      Related Anatomy
                                      Loading...
                                      Related Differential Diagnoses
                                      Loading...
                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Craniocervical junction (CCJ) injuries
                                                • Definitions

                                                  • Traumatic injury to upper cervical region: Occiput to C2
                                                    • Much more common in 1st decade than in older children & adults
                                                • Types of CCJ Injuries

                                                  • Atlantooccipital dissociation (AOD)
                                                    • (a.k.a. atlantooccipital dislocation; occipitocervical dissociation)
                                                  • Atlantoaxial dissociation
                                                    • (a.k.a. atlantoaxial dislocation)
                                                  • Jefferson fracture (C1 ring)
                                                  • Odontoid (C2) fracture
                                                  • Hangman (C2) fracture
                                                  • Atlantoaxial rotatory fixation
                                                  • Spinal cord injury without radiographic abnormality

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Nonvascular Interventions

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Consider

                                                                          Selected References

                                                                          1. Corcoran B et al: Application of normative occipital condyle-C1 interval measurements to detect atlanto-occipital injury in children. AJNR Am J Neuroradiol. 37(5):958-62, 2016
                                                                          2. Smith P et al: Normal development and measurements of the occipital condyle-C1 interval in children and young adults. AJNR Am J Neuroradiol. 37(5):952-7, 2016
                                                                          3. Dorney K et al: Outcomes of pediatric patients with persistent midline cervical spine tenderness and negative imaging result after trauma. J Trauma Acute Care Surg. 79(5):822-7, 2015
                                                                          4. Hannon M et al: Pediatric cervical spine injury evaluation after blunt trauma: a clinical decision analysis. Ann Emerg Med. 65(3):239-47, 2015
                                                                          5. Vachhrajani S et al: Estimation of normal computed tomography measurements for the upper cervical spine in the pediatric age group. J Neurosurg Pediatr. 14(4):425-33, 2014
                                                                          6. Astur N et al: Traumatic atlanto-occipital dislocation in children: evaluation, treatment, and outcomes. J Bone Joint Surg Am. 95(24):e194(1-8), 2013
                                                                          7. Gargas J et al: An analysis of cervical spine magnetic resonance imaging findings after normal computed tomographic imaging findings in pediatric trauma patients: ten-year experience of a level I pediatric trauma center. J Trauma Acute Care Surg. 74(4):1102-7, 2013
                                                                          8. Henry M et al: A retrospective comparison of CT and MRI in detecting pediatric cervical spine injury. Childs Nerv Syst. 29(8):1333-8, 2013
                                                                          9. Booth TN: Cervical spine evaluation in pediatric trauma. AJR Am J Roentgenol. 198(5):W417-25, 2012
                                                                          10. Chung S et al: Trauma association of Canada Pediatric Subcommittee National Pediatric Cervical Spine Evaluation Pathway: consensus guidelines. J Trauma. 70(4):873-84, 2011
                                                                          11. Junewick JJ: Pediatric craniocervical junction injuries. AJR Am J Roentgenol. 196(5):1003-10, 2011
                                                                          12. Leonard JC et al: Factors associated with cervical spine injury in children after blunt trauma. Ann Emerg Med. 58(2):145-55, 2011
                                                                          13. Junewick JJ: Cervical spine injuries in pediatrics: are children small adults or not? Pediatr Radiol. 40(4):493-8, 2010
                                                                          14. Bertozzi JC et al: Evaluation of the pediatric craniocervical junction on MDCT. AJR Am J Roentgenol. 192(1):26-31, 2009
                                                                          15. Junewick JJ et al: Occult injury of the pediatric craniocervical junction. Emerg Radiol. 16(6):483-8, 2009