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Canadian Journal of Surgery. Journal... Dec 2001To provide an overview of atlanto-occipital dislocation and associated occipital condyle fracturcs so as to alert physicians to this rare injury and potentially improve... (Review)
Review
OBJECTIVE
To provide an overview of atlanto-occipital dislocation and associated occipital condyle fracturcs so as to alert physicians to this rare injury and potentially improve patient outcome. The pertinent anatomy, mechanism of injury, clinical and radiologic evaluation and the management of these rare injuries are discussed in an attempt to alert physicians to this type of injury and to improve outcome.
DATA SOURCES
The data were obtained from a MEDLINE search of the English literature from 1966 to 1999 and the experience of 4 spine surgeons at a quaternary care acute spinal cord injury unit.
STUDY SELECTION
Detailed anatomic and epidemiologically sound radiology studies were identified and analyzed. Only small retrospective studies or case series were available in the literature.
DATA EXTRACTION
Valid anatomic, biomechanical and radiologic evaluation was extracted from studies. Clinical data came from limited studies and expert opinion.
DATA SYNTHESIS
Early diagnosis is essential and is facilitated by a detailed clinical examination and strict adherence to an imaging algorithm that includes CT and MRI scanning. When the dislocation is identified, timely gentle reduction and prompt stabilization throuigh nonoperative or operative means is found to optimize patient outcome.
CONCLUSIONS
Atlanto-occipital dislocation should be suspected in any patient involved in a high speed motor vehicle or pedestrian collision. Once suspected, proper imaging and appropriate management of these once fatal injuries can improve survival and neurologic outcome.
Topics: Atlanto-Occipital Joint; Humans; Joint Dislocations; Occipital Bone; Radiography; Skull Fractures; Survival Rate
PubMed: 11764873
DOI: No ID Found -
The Angle Orthodontist Jul 2021To examine the correlation between spheno-occipital synchondrosis fusion stages and the hand-wrist skeletal maturity index.
OBJECTIVES
To examine the correlation between spheno-occipital synchondrosis fusion stages and the hand-wrist skeletal maturity index.
MATERIALS AND METHODS
Digital records of 164 individuals (77 males, 87 females) aged 10 to 18 years old were examined. Three-dimensional CBCT scans and hand-wrist two-dimensional radiographs were scored for the spheno-occipital synchondrosis fusion stages and hand-wrist skeletal maturity index, respectively. Statistical analyses were performed for associations using R software with a significance threshold of P< .01.
RESULTS
A significant positive relationship was demonstrated between spheno-occipital synchondrosis fusion stages and hand-wrist skeletal maturity in both sexes. The Kendall's rank correlation τ between hand-wrist skeletal maturity index and spheno-occipital synchondrosis fusion percentage were high and positive in males and females (r = .74 and r = .71, respectively).
CONCLUSIONS
The significant, positive relationship between the hand-wrist skeletal maturity index and spheno-occipital synchondrosis fusion stages support the idea of using spheno-occipital synchondrosis fusion as a biological indicator for craniofacial and mandibular growth spurt prediction.
Topics: Adolescent; Age Determination by Skeleton; Child; Cone-Beam Computed Tomography; Female; Humans; Male; Occipital Bone; Sphenoid Bone; Wrist
PubMed: 33544141
DOI: 10.2319/062920-596.1 -
Medicina 2016
Topics: Fibrous Dysplasia, Monostotic; Humans; Magnetic Resonance Imaging; Male; Occipital Bone; Temporal Bone; Tomography, X-Ray Computed; Young Adult
PubMed: 27576287
DOI: No ID Found -
Journal of Orthopaedic Surgery (Hong... 2019The purpose of this study was to evaluate the feasibility of posterior occipital condyle screw (OCS) placement analysis of the safe trajectory area for screw insertion.
OBJECTIVE
The purpose of this study was to evaluate the feasibility of posterior occipital condyle screw (OCS) placement analysis of the safe trajectory area for screw insertion.
METHODS
Computed tomographic angiography scans of patients (46 males and 27 females) with normal occipitocervical structures were obtained consecutively. Vertebral artery (VA)-occiput distance <4.0 mm was defined as "unfeasible" for OCS fixation, and occipital-atlas angulation was measured to assess the feasibility of screw placement. Next, the placement of 3.5 mm diameter OCS was simulated, the probability of breach of structures surrounding occipital condyles was calculated, and placement parameters were analyzed.
RESULTS
OCS placement was feasible in 91.1% (133/146) of occipital condyles, and the feasible probability also presented a significant sex-related difference: The probability was higher for males than for females (95.7% vs. 83.3%, < 0.05). The incidence of anatomical structures injured under screw placement limitation was 18.8% (VA), 81.2% (hypoglossal canal), 59.4% (occipital-atlas joint), and 40.6% (occiput bone surface). There were no significant differences between the left and right condyles in relation to the measured parameters ( > 0.05). The screw range of motion was significantly smaller in females than in males ( < 0.05). The feasibility of OCS placement and OCS range of motion were significantly greater in the kyphosis group (>5°) than in the other two groups ( < 0.05).
CONCLUSION
OCS placement is a feasible technique for occipital-cervical fusion. The male group and occipitocervical region kyphosis group had a wider available space for OCS placement. Tangent angulation may be useful for the accurate and safe placement of an OCS.
Topics: Adult; Aged; Bone Screws; Computed Tomography Angiography; Computer Simulation; Female; Humans; Imaging, Three-Dimensional; Kyphosis; Male; Middle Aged; Occipital Bone; Spinal Fusion; Young Adult
PubMed: 31645192
DOI: 10.1177/2309499019879540 -
Journal of Anatomy Nov 2016Development of somites leading to somite compartments, sclerotome, dermomyotome and myotome, has been intensely investigated. Most knowledge on somite development,...
Development of somites leading to somite compartments, sclerotome, dermomyotome and myotome, has been intensely investigated. Most knowledge on somite development, including the commonly used somite maturation stages, is based on data from somites at thoracic and lumbar levels. Potential regional differences in somite maturation dynamics have been indicated by a number of studies, but have not yet been comprehensively examined. Here, we present an overview on the developmental dynamics of somites at occipital and cervical levels in the chicken embryo. We show that in these regions, the onset of sclerotomal and myotomal compartment formation is later than at thoracolumbar levels, and is initiated simultaneously in multiple somites, which is in contrast to the serial cranial- to- caudal progression of somite maturation in the trunk. Our data suggest a variant spatiotemporal regulation of somite development in occipitocervical somites.
Topics: Animals; Cell Differentiation; Cervical Vertebrae; Chick Embryo; Embryonic Development; In Situ Hybridization; Occipital Bone; Somites
PubMed: 27380812
DOI: 10.1111/joa.12516 -
Revista de Neurologia Apr 2015Growing skull fracture, also known as post-traumatic bone absorption or leptomeningeal cyst, is a rare complication of traumatic brain injuries and occurs almost... (Review)
Review
INTRODUCTION
Growing skull fracture, also known as post-traumatic bone absorption or leptomeningeal cyst, is a rare complication of traumatic brain injuries and occurs almost exclusively in children under 3 years of age.
CASE REPORT
We report the case of a 6-month-old child who presented, two months after an apparently unimportant traumatic skull injury, persistence of left temporoparietooccipital cephalohaematoma with no other signs. A transfontanellar ultrasonography scan revealed a bone defect with brain herniation, and computerised tomography and magnetic resonance imaging also confirmed the existence of a growing fracture. Excision of the leptomeningeal cyst, dural closure and repair of the bone defect with plates and lactate material were performed. Three months after the operation, the patient still presented collection of fluid and recurrence of the growing fracture was confirmed. Following the second operation, a baby helmet was fitted in order to prevent renewed recurrences. One year after the traumatic injury occurred, the patient remains asymptomatic.
CONCLUSIONS
Any child under 3 years of age with a post-traumatic cephalohaematoma should be checked periodically until the full resolution of the collection of fluid, especially if they present a fractured skull. The presence of a cephalohaematoma that remains more than two weeks after traumatic brain injury must make us suspect a growing fracture and reparation of the dura mater and a cranioplasty will be needed to treat it. The use of resorbable material allows it to be remodelled as the patient's skull grows, but its fragility increases the risk of recurrence. The use of a baby helmet after the operation could prevent complications.
Topics: Absorbable Implants; Accidental Falls; Arachnoid Cysts; Craniocerebral Trauma; Disease Progression; Dura Mater; Encephalocele; Head Protective Devices; Hematoma, Epidural, Cranial; Humans; Imaging, Three-Dimensional; Infant; Magnetic Resonance Imaging; Male; Occipital Bone; Parietal Bone; Prostheses and Implants; Plastic Surgery Procedures; Recurrence; Skull Fractures; Tomography, X-Ray Computed
PubMed: 25857859
DOI: No ID Found -
The Iowa Orthopaedic Journal 2008Xanthoma of bone is a rare bone disorder characterized as a lytic lesion, often with cortical expansion or disruption. Because of its aggressive radiographic appearance,... (Review)
Review
Xanthoma of bone is a rare bone disorder characterized as a lytic lesion, often with cortical expansion or disruption. Because of its aggressive radiographic appearance, other primary bone tumors and metastatic lesions need to be ruled out. we present three cases of intraosseous xanthoma: one occurring as a pathologic fracture in the distal tibia, one discovered incidentally in the iliac crest in a patient with hip pain, and one discovered incidentally in the occipital bone of the skull in a child with widespread Hodgkin's lymphoma. All patients were treated with curettage of the lesions; craniectomy followed by cranioplasty for the occipital lesion, and curettage followed by internal fixation and bone grafting for the tibial lesion. The lesion in the iliac crest was treated with curettage and bone grafting. At the most recent follow-up (12, 15, and 24 months for patients with occipital, iliac crest, and tibial lesions, respectively), there was no evidence of local recurrence.
Topics: Adult; Bone Diseases; Child; Diagnosis, Differential; Humans; Ilium; Male; Occipital Bone; Tibia; Tomography, X-Ray Computed; Xanthomatosis
PubMed: 19223950
DOI: No ID Found -
AJNR. American Journal of Neuroradiology May 2016Widening of the occipital condyle-C1 interval is the most specific and sensitive means of detecting atlanto-occipital dislocation. Recent studies attempting to define...
BACKGROUND AND PURPOSE
Widening of the occipital condyle-C1 interval is the most specific and sensitive means of detecting atlanto-occipital dislocation. Recent studies attempting to define normal measurements of the condyle-C1 interval in children have varied substantially. This study was performed to test the null hypothesis that condyle-C1 interval morphology and joint measurements do not change as a function of age.
MATERIALS AND METHODS
Imaging review of subjects undergoing CT of the upper cervical spine for reasons unrelated to trauma or developmental abnormality was performed. Four equidistant measurements were obtained for each bilateral condyle-C1 interval on sagittal and coronal images. The cohort was divided into 7 age groups to calculate the mean, SD, and 95% CIs for the average condyle-C1 interval in both planes. The prevalence of a medial occipital condyle notch was calculated.
RESULTS
Two hundred forty-eight joints were measured in 124 subjects with an age range of 2 days to 22 years. The condyle-C1 interval varies substantially by age. Average coronal measurements are larger and more variable than sagittal measurements. The medial occipital condyle notch is most prevalent from 1 to 12 years and is uncommon in older adolescents and young adults.
CONCLUSIONS
The condyle-C1 interval increases during the first several years of life, is largest in the 2- to 4-year age range, and then decreases through late childhood and adolescence. A single threshold value to detect atlanto-occipital dissociation may not be sensitive and specific for all age groups. Application of this normative data to documented cases of atlanto-occipital injury is needed to determine clinical utility.
Topics: Adolescent; Atlanto-Occipital Joint; Cervical Vertebrae; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Occipital Bone; Reference Values; Tomography, X-Ray Computed; Young Adult
PubMed: 26514612
DOI: 10.3174/ajnr.A4543 -
BMC Oral Health Dec 2022This study aimed to compare spheno-occipital synchondrosis (SOS) maturation stages with a three-dimensional assessment of mandibular growth.
BACKGROUND
This study aimed to compare spheno-occipital synchondrosis (SOS) maturation stages with a three-dimensional assessment of mandibular growth.
METHODS
This is a cross-sectional study of a retrospective type, in which cone-beam computed tomography (CBCT) images of 500 patients aged 6 to 25 years (226 males and 274 females) were analyzed. The SOS was evaluated using the four-stage scoring system; completely open, partially fused, semi-fused, or completely fused. The SOS scoring and three-dimensional cephalometric measurements were analyzed by Invivo 6.0.3 software. Descriptive and analytical statistics were performed, and a P-value < 0.05 was considered statistically significant.
RESULTS
There was a statistically significant difference in mandibular measurements among SOS maturation stages in both sexes (P < 0.05). The skeletal growth increments of mandibular variables across the SOS stages had higher mean differences between SOS stages 2 and 3 than those between stages 1 and 2 and stages 3 and 4 in both sexes. The mandibular growth curves increased with chronological age (earlier in females) and SOS maturation stages (mostly in stages 1, 2, and 3 than stage 4).
CONCLUSIONS
The SOS maturation stages are valid and reliable mandibular skeletal indicators as evaluated with three-dimensional cephalometric mandibular measurements. The findings of growth increments and constructed growth curves of mandibular growth might be helpful in diagnosis and treatment planning.
Topics: Male; Female; Humans; Occipital Bone; Sphenoid Bone; Retrospective Studies; Cross-Sectional Studies; Mandible; Cone-Beam Computed Tomography
PubMed: 36585639
DOI: 10.1186/s12903-022-02692-3 -
The Canadian Veterinary Journal = La... Oct 2023This report describes the clinical, computed tomography, and magnetic resonance imaging findings for a Jacob sheep lamb diagnosed with meningoencephalocele and...
This report describes the clinical, computed tomography, and magnetic resonance imaging findings for a Jacob sheep lamb diagnosed with meningoencephalocele and supernumerary ectopic limb. Key clinical message: This case demonstrates the utility of tomographic imaging in diagnosing congenital malformations in sheep and can be used to assess the extent of the lesion. This may help to determine any viable treatment, or, as in the case presented here, determine that the extent of the lesion precludes surgical intervention.
Topics: Animals; Sheep; Encephalocele; Meningocele; Occipital Bone; Extremities; Tomography, X-Ray Computed; Magnetic Resonance Imaging; Sheep Diseases
PubMed: 37780471
DOI: No ID Found