PubMed · 4033491
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N Bogduk, B Corrigan, P Kelly, G Schneider, R Farr. 1985-09-02. Cervical headache.. https://doi.org/10.5694/j.1326-5377.1985.tb122915.x
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A case of an eight-year-old boy who had sustained both a fractured clavicle and rotatory atlanto-axial fixation is described. The last diagnosis was missed for four and a half months. The diagnosis was made in combination with cineroentgenography and computed tomography scanning. Conservative treatment with external traction was first attempted, after which the patient was operated twice with posterior fusion between C-1 and C-2. At six month follow-up the child was without pain, had neutral head holding and about two-thirds of normal rotation.
Case reports are presented on 2 children who had suffered traumatic luxations in the region of the cranial cervical spine. In both children, there was interruption of spinal cord continuity by severance with respiratory arrest and tetraplegia. As a rule, death occurs immediately at the site of accident. With a well-developed emergency ambulance system in conurbations, however, such cases may be admitted to hospital after resuscitation. After 16 hours, a child admitted to hospital died of a progressive bradycardia with subsequent asystole in respiratory paralysis. The second child survived for 10 months until it died of pneumonia.
The craniocervical junction is a highly specialized unit simultaneously supporting head during movements in all planes and protecting the spinal cord. Anatomically, it includes an atlantoaxial complex, part of which embryonically arises from the occipital region of the skull. This review deals with the gross anatomy, kinematics, and growth reactions associated with functional alteration in this complex. Particular attention is paid to the atlas, the connecting element between the head and the vertebral column proper. From several studies it is concluded that the horizontal growth of the atlas is regulated by synchondroseal growth, whereas the vertical growth is determined by appositional growth. Some vertebral anomalies and concomitant anomalies of the cranial base are reported, to point out the ontogenetic integration between the skull base and the craniocervical junction. The high frequencies of atlantal posterior arch deficiency in cleft palate patients have led to speculations about common etiologic factors in these conditions.