Occipital Condyle Trauma

ABSTRACT

Traumatic lesions involving the occipital condyles and their ligamentous structures are infrequently seen in neurosurgical practice. The clinical spectrum of these injuries is vast and varies from the highly unstable occipitocervical dislocation to relatively insignificant and uncomplicated occipital condyle fractures.

These injuries can be very difficult to diagnose on plain films. A high index of suspicion and a low threshold for further definitive imaging is warranted. Significant closed head injuries, lower cranial nerve deficits, brainstem dysfunction, and other cervical spine fractures have been associated with C0 trauma. Thin-section computed tomography (CT) with coronal and sagittal reformatting of the craniocervical junction should be considered as the minimum standard of care in these patients. In patients in which occipital injury is clinically suspected and CT is inconclusive, magnetic resonance imaging (MRI) is indicated. Occipital condyle fractures can generally be treated by external immobilization, whereas occipitocervical dislocations mandate immediate rigid external immobilization followed by early occipitocervical fixation and fusion.

KEYWORDS

Occipitocervical dislocation - occipital condyle fracture - occipitocervical fusion

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