Traumatic atlanto-occipital dislocation (AOD) is an ominous injury with high mortality and morbidity in trauma patients. Improved survival has been observed wit
What happens during an injection?. A local anesthetic will be used to numb your skin. The doctor will then insert a thin needle directly into the atlanto-occipital joint. Fluoroscopy, a type of x-ray, must be used to ensure the safe and proper position of the needle. A dye may also be injected to make sure the needle is at the correct spot.. When the doctor is sure the needle is at the correct place, the anesthetic and steroid will be injected.. What happens after an AO injection?. You will be monitored for up to 30 minutes after the injection. When you are ready to leave, the staff will give you discharge instructions and a pain diary. It is important to fill out the pain diary because it helps your doctor know how the injection is working.. It may help to move your neck in ways that hurt before the injection, to see if the pain is still there, but do not overdo it. Take it easy for the rest of the day.. You may feel immediate pain relief and numbness in your upper neck for a period of time ...
The atlanto-occipital articulations function as bilaterally symmetrical joints, each of which is formed by an occipital condyle and a superior articular facet of the atlas. Each is classified as an ellipsoidal joint because of its shape. The capsule is rather roomy and relaxed and the joint possesses no individual accessory ligaments ...
This study describes the ultrasonographic appearance of the atlanto-occipital space and ultrasound-guided collection of cerebrospinal fluid (CSF) in cattle. The atlanto-occipital space of 73 euthanized cattle (group A) and 14 live cattle with neurological disorders (group B) was examined in the sagittal and transverse planes using a 5.0-MHz convex transducer. Optimal ultrasonograms were frozen on the screen and various variables were measured in both planes using the electronic cursors. Puncture of the subarachnoid space was achieved using a spinal needle introduced in the median plane in a caudoventral direction while the spinal cord was viewed in longitudinal section. The examination of cerebrospinal fluid (CSF) was limited to gross evaluation and a red blood cell count. The spinal cord and the subarachnoid space were seen in the sagittal plane in all cattle. In group A, the mean distance between the skin and subarachnoid space was 38.6 mm, the mean depth of the subarachnoid space dorsal and ventral
Steffen F, Flueckiger M, Montavon PM. Vet Surg 2003;32:411-415. OBJECTIVE: To present a detailed description of a dog with atlanto-occipital (A-O) luxation,
A broad, thin ligamentous sheet that connects the posterior rim of the foramen magnum to the superior border of the posterior arch of the atlas. The lateral aspects of the membrane blend with the posterior surfaces of the atlanto-occipital joint capsules. It is equivalent to the ligamentum flavum at other vertebral levels ...
A broad, thin ligamentous sheet that connects the posterior rim of the foramen magnum to the superior border of the posterior arch of the atlas. The lateral aspects of the membrane blend with the posterior surfaces of the atlanto-occipital joint capsules. It is equivalent to the ligamentum flavum at other vertebral levels ...
A broad fibrous sheet that binds the anterior edge of the foramen magnum to the superior margin of the anterior arch of the atlas. The thickened median portion of this membrane is the continuation of the anterior longitudinal ligament. Laterally it covers the anterior surface of the atlanto-occipital joints ...
The posterior atlantooccipital membrane (posterior atlantooccipital ligament) is a broad but thin membrane. It is connected above to the posterior margin of the foramen magnum and below to the upper border of the posterior arch of the atlas. On each side of this membrane there is a defect above the groove for the vertebral artery which serves as an opening for the entrance of the artery. The suboccipital nerve also passes through this defect. The free border of the membrane arches over the artery and nerve and is sometimes ossified. The membrane is deep to the Recti capitis posteriores minores and Obliqui capitis superiores and is superficial to the dura mater of the vertebral canal to which it is closely associated. In 2015, Scali et al. revisited the anatomy of the posterior atlantooccipital membrane via plastination. Their findings revealed that the PAO membrane superiorly consisted of periosteum of the occiput, whereas inferiorly it formed part of the dura at the cerebrospinal junction, ...
Posterior occipitocervical fixation and fusion are often required to address occipitocervical instability. Safe, stable internal fixation with screws is vital for the success of such surgery. Thus, poor selection of an internal fixation technique may cause fixation and fusion failure, possibly leading to neurovascular injury. Hence, in certain cases, such as in patients with severe instability of an occipitocervical deformity or osteoporosis, we hypothesized that having a third anchor point (a screw in C2) could enhance the stability of the occipitocervical fixation. A 31-year-old man with occipitocervical deformity and spinal cord edema underwent a traditional occipitocervical fixation procedure but with the addition of a spinous process screw in C2 as a third anchor point. The procedure included posterior internal fixation and fusion. The occipitocervical fixation was completed by inserting occipital screws, bilateral C2 pedicle screws, C3 lateral mass screws, and a spinous process screw in C2 as a
The C1 and C2 vertebra and the occipital bone of the skull form the atlanto-occipital joint. This type of joint is a synovial joint and allows flexion and extension. This allows the head to make...
The rectus capitis posterior major (or rectus capitis posticus major, both being Latin for larger posterior straight muscle of the head) arises by a pointed tendon from the spinous process of the axis, and, becoming broader as it ascends, is inserted into the lateral part of the inferior nuchal line of the occipital bone and the surface of the bone immediately below the line.. A soft tissue connection bridging from the rectus capitis posterior major to the cervical dura mater was described in 2011. Various clinical manifestations may be linked to this anatomical relationship.[1] It has also been postulated that this connection serves as a monitor of dural tension along with the rectus capitis posterior minor and the obliquus capitis inferior.. As the muscles of the two sides pass upward and lateralward, they leave between them a triangular space, in which the rectus capitis posterior minor is seen.. Its main actions are to extend and rotate the atlanto-occipital joint.. ...
Lets begin with a little coding and documentation background. According to the American Medical Association, chiropractic manipulative treatment (CMT) is a form of manual treatment to influence joint and neurophysiological function. The CMT codes include a pre-manipulation patient assessment. Additional evaluation and management (E/M) services may be reported separately using modifier 25, if the patients condition requires a separate E/M service, above and beyond the usual pre-service and post-service. The E/M service may be caused or prompted by the same symptoms or condition for which the CMT service was provided. As such, different diagnoses are not required for the reporting of the CMT and E/M service on the same date.. For purposes of CMT, the five spinal regions referred to are: cervical region (includes atlanto-occipital joint); thoracic region (includes costovertebral and costotransverse joints); lumbar region; sacral region; and pelvic (sacro-iliac joint) region.. ...
Tracheal intubation is generally considered the best method for airway management under a wide variety of circumstances, as it provides the most reliable means of oxygenation and ventilation and the greatest degree of protection against regurgitation and pulmonary aspiration.[2] However, tracheal intubation requires a great deal of clinical experience to master[81] and serious complications may result even when properly performed.[82]. Four anatomic features must be present for orotracheal intubation to be straightforward: adequate mouth opening (full range of motion of the temporomandibular joint), sufficient pharyngeal space (determined by examining the back of the mouth), sufficient submandibular space (distance between the thyroid cartilage and the chin, the space into which the tongue must be displaced in order for the larygoscopist to view the glottis), and adequate extension of the cervical spine at the atlanto-occipital joint. If any of these variables is in any way compromised, ...
At the atlanto-occipital joint, the joint between the neck and the skull, the rectus capitis anterior muscle takes care of flexing the neck, allowing the head to nod downward. This takes place at a low region on the back the skull.
TY - JOUR. T1 - Traumatic occipitoatlantal dislocation. AU - Montane, Ismael. AU - Eismont, Frank J.. AU - Green, Barth A.. PY - 1991/2. Y1 - 1991/2. N2 - Four patients with traumatic occipitoatlantal dislocation are presented. The dislocations were the result of rapid deceleration motor vehicle accidents. The mechanism of injury was by hyperextension-rotation combined with a distraction force. Three patients sustained multiple injuries. Neurologic findings were variable. One patient with complete cord transection and closed head trauma died 4 days after the injury. In the three surviving patients, the occipitoatlantal dislocation was not diagnosed by the initial examiner. Prompt recognition and stabilization are essential to avoid further neurologic injury. Care must be taken not to increase the dislocation. A halo applied before operation facilitates reduction and allows posterior occipitoatlantal fusion to be performed under optimum conditions.. AB - Four patients with traumatic ...
Numerous reports of atlantooccipital dislocations (AODs) have been described in frontal impacts and vehicle versus pedestrian collisions. Reports of survival after AOD in conjunction with side impacts have infrequently been reported in the literature. The objective of this study is to present a case of an AOD from a side impact vehicle collision, and deduce the mechanism of injury. A clinical and biomechanical reconstruction of the collision was performed to investigate the mechanism of the dislocation. A 51-year-old female was traveling in a four-door sedan and sustained a side impact collision with a compact pickup truck. At the time of extrication, the patient was neurologically intact with a Glasgow Coma Scale score of 15. After admittance to the hospital, the patient developed a decline in respiratory status, right mild hemiparesis, and left sixth-nerve palsy, and magnetic resonance imaging (MRI) and computed tomography (CT) reconstructions indicated a craniocervical dislocation. Surgical ...
Anterior view of structures at atlantooccipital region. Bone of the lower clivus and adjacent parts of the occipital bone were removed to expose...
Atlanto-occipital dislocation is a highly unstable craniocervical injury, resulting from damage to ligaments and/or bony structures connecting the skull to
In the previous studies, the stroke mechanism of patients with infarction aged below 50 years was reported [1]-[3]. According to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification of stroke mechanism, the proportion of other determined etiology in young-age stroke is rather high: large-artery atherosclerosis, 11%, cardioembolism, 24%, small-artery occlusion, 8%, stroke of other determined etiology, 27%, and stroke of undetermined etiology, 29% [3]. Vertebral arterial injuries associated with structural osseous anomaly, one of other determined etiology, have been reported [4],[5].. Anomalous occipital bony process may be a byproduct of fusion abnormalities [6]-[8]. The incidence of anomaly of atlanto-occipital fusion that could cause compression of the vertebral artery varies between 0.5% and 1.0% [6],[7]. The symptoms may be headache, neck pain, numbness, and weakness in the limbs, or cranial nerve dysfunction including tinnitus, visual disturbance, dysphagia, or dysarthria ...
A method and system for thermal-dynamic modeling and performance evaluation of a nuclear Boiling Water Reactor (BWR) core design is presented. A data processing system is used to execute specific program routines that simultaneously simulate the thermal operating characteristics of fuel rods within the reactor during a transient operational condition. The method employs a multi-dimensional approach for the simulation of postulated operational events or an anticipated operational occurrence (AOO) which produces a transient condition in the reactor-such as might be caused by single operator error or equipment malfunction. Based on a generic transient bias and uncertainty in the change in critical power ratio (ΔCPR/ICPR), histograms of fuel rod critical power ratio (CPR) are generated. Ultimately, the operating limit minimum critical power ratio (OLMCPR) of the reactor is evaluated from a histogram of probability calculations representing the number of fuel rods subject to a boiling transition (NRSBT)
The unilateral transection of the cerebellar peduncles was performed on 29 rats (Table 1). In these animals the atlanto-occipital membrane was exposed and excised, and the cerebellar peduncles of one side was cut by inserting a microknife into the fourth ventricle underneath the cerebellum. These animals belong to an experimental set described in a previous study to which it can be referred for details about the surgical procedures and the evaluation of lesion extent (Buffo et al., 1998).. The Purkinje cell axonal transport was blocked in vivo by injecting a colchicine solution into the cerebellar parenchyma of uninjured rats. These animals were placed on a stereotaxic frame, the occipital bone was exposed, and a hole was drilled in the superior aspect to expose the cerebellar vermis. A total of 4 μg of either colchicine (n = 17, Table 1) or β-lumicolchicine, as a control (n = 4, Table 1), diluted in 1 μl of saline solution was pressure-injected 1 mm deep within the cerebellar parenchyma ...
This issue of Acta Neurochirururgica presents the latest surgical and experimental approaches to the craniovertebral junction (CVJ). It discusses anterior
Craniocervical Junction Disorders - Learn about the causes, symptoms, diagnosis & treatment from the Merck Manuals - Medical Consumer Version.
Craniocervical Junction Disorders - Learn about the causes, symptoms, diagnosis & treatment from the MSD Manuals - Medical Consumer Version.
Learn about the causes, symptoms, diagnosis & treatment of Craniocervical Junction Disorders from the Home Version of the Merck Manuals.
Dean, C. B., Bellhouse, D. R., Brown, S., Froda, S. and Heckman, N. (2015). Vignette 7.1 A glimpse into women who lay the foundation for the development of statistics in Canada. Advancing Women in Science: An International Perspective , 219-225 ...
Fingerprint Dive into the research topics of A new technique for intraoperative reduction of occipitocervical instability.. Together they form a unique fingerprint. ...
The post defines the peak to average power ratio (PAPR) and using matlab/octave script, computes the cumulative distribuition function (CDF) of PAPR for 802.11a specification.
The post defines the peak to average power ratio (PAPR) and using matlab/octave script, computes the cumulative distribuition function (CDF) of PAPR for 802.11a specification.
The vertebral arteries pass through the intervertebral foramen of the axis before passing through the anterior atlantooccipital membrane to enter the suboccipitial triangle ...
RAFAILIDIS, SV and CLIFT, R (1990) MODELING IN PARALLEL WITH TRANSPUTERS OF BUBBLE FLOWS IN FLUIDIZED-BEDS In: 1ST INTERNATIONAL CONF ON PARALLEL PROCESSING FOR COMPUTATIONAL MECHANICS, 1990-09-04 - 1990-09-06, SOUTHAMPTON, ENGLAND. REESON, KJ, STANLEY, CJ, JEYNES, C, GRIME, G and WATT, F (1990) PIXE ANALYSIS TO DETERMINE THE TRACE-ELEMENT CONCENTRATIONS IN A SERIES OF GALENA (PBS) SPECIMENS FROM DIFFERENT LOCALITIES In: 9TH INTERNATIONAL CONF ON ION BEAM ANALYSIS, 1989-06-26 - 1989-06-30, QUEENS UNIV, KINGSTON, CANADA. Rodin, VV, Voinova, II, Volkov, VI, Volkova, LA, Moiseeva, EV and Dozmorov, IM (1990) Study by electron paramagnetic resonance of blood plasma of mice during rotation stress associated with administration of ascorbic acid and GABA ...
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List Price: $199.00. ADD TO SHOPPING CART. This text includes stabilization techniques for the entire spinal column, ranging from the cranio-cervical junction to the pelvis. The information is presented in an easily digestible format that is suitable for those in school or training, yet includes pearls and insight that can be appreciated by even the most seasoned surgeon. The text is divided into major sections based on the anatomical regions of the spine - cervical, thoracic, and lumbosacral. An additional section is devoted to related surgical concepts and principles such as spinal biomechanics and bone grafting options. Each chapter has a uniform design including background, indications, patient selection, preoperative considerations, surgical technique, technical pearls, and strategies for complication avoidance. Preoperative and postoperative images and/or illustrations are utilized to highlight the presented information.. ...
The other thing that is progressing is my cranio-cervical instability. During spells, I feel my brain ache and feel heavy, and I get extreme nausea. I know that this is the exact feeling that restricted me to bed not so many years ago. In some ways, I cant wait for the fusion surgery to come...no matter what I have to go through, in the hopes that I may actually get better this time. I think there is reason to believe that this is the time. This is the surgery that will finally help! I hope I dont have to become completely debilitated before it is time for surgery, though ...
Craniocervical syndromes may be a key culprit in many neurological and neurodegenerative conditions similar to their role in Ehlers-Danlos and multiple sclerosis.