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Joseph Junewick, MD FACR
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Craniocervical Injury

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

4 year old male with humerus fracture, alert and talking after involvement in head on collision.


Case Images


Diagnosis

Craniocervical injury

Clinical Notes

Two other persons dead on the scene.

Findings

MR – Disruption of apico-clival ligament, atlanto-axial joint fluid, elevation of tectorial membrane and precervical edema/hemorrhage. No cord contusion or edema.

Discussion

The constellation of findings in this case is related to transient and incomplete atlanto-occipital dissociation. This injury is quite common in children less than 8 years of age involved in deceleration trauma because of shallow atlanto-occipital joints, lax craniocervical ligamentous support and relatively large head size. The implications are not fully known but in the absence of cord injury and frank ligamentous diruption the prognosis is probably very good.

Reference

Junewick JJ et al. Occult injury of the pediatric craniocervical junction. Emergency Radiology 2009.



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