Internal Decapitation – Atlanto-Occipital Dislocation

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atlanto-occipital dislocation, or orthopedic decapitation describes the rare medical condition in which the skull separates from the spinal column during severe head injury. This is generally fatal, since it generally involves nerve damage or severing the spinal cord.

This Article from Hosalkar et al Describes 16 cases in the pediatric population occuring between 1986 and 2003.

Article Conclusions and practice recommendations

Prompt recognition and treatment of traumatic atlanto-occipital dislocation in children and adolescents can result in improved survival. Early diagnosis, prompt intubation, early and adequate immobilization of the head and neck, and the use of intravenous steroids appear to facilitate survival. We recommend arthrodesis from the occiput to C2 (or the nearest adjacent intact and stable vertebra caudad to C2) for all children who survive a traumatic atlanto-occipital dislocation, particularly those with an incomplete spinal cord injury.

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