Sharma Ashish, Nguyen Ha Son, Sharma Abhishiek, Lozen Andrew, Kurpad Shekar
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Surg Neurol Int. 2016 Sep 22;7(Suppl 25):S679-S681. doi: 10.4103/2152-7806.191076. eCollection 2016.
Traumatic atlanto-occipital dislocation (AOD) is a rare but often fatal injury. Consequently, long-term data regarding surviving patients have been limited. In particular, the occurrence of hydrocephalus is not well-documented.
A 33-year-old male sustained AOD as a consequence of a motor vehicle collision. Although he did well initially after an occipitocervical fusion, 1 month after his operation, he exhibited signs of increased intracranial pressure (bilateral abducens nerve palsies, worsening headaches, and fatigue). He was found to have hydrocephalus, which was responsive to shunting.
Manifestations of hydrocephalus after AOD can be variable, ranging from interval ventricular dilatation to pseudomeningoceles and syringomyelia. In addition, the timing of presentation can be acute, requiring emergent external ventricular drainage, or delayed, requiring ongoing vigilance. Consequently, as more patients survive this once thought to be fatal injury, caution for hydrocephalus is stressed.
创伤性寰枕关节脱位（AOD）是一种罕见但往往致命的损伤。因此，关于幸存患者的长期数据有限。特别是，脑积水的发生情况记录不详。
一名33岁男性因机动车碰撞导致AOD。尽管他在枕颈融合术后初期情况良好，但术后1个月，他出现了颅内压升高的症状（双侧展神经麻痹、头痛加重和疲劳）。他被发现患有脑积水，分流治疗有效。
AOD后脑积水的表现可能多种多样，从间隔性脑室扩张到假性脑脊膜膨出和脊髓空洞症。此外，出现症状的时间可以是急性的，需要紧急进行脑室外引流，也可以是延迟的，需要持续警惕。因此，随着越来越多的患者从这种曾被认为致命的损伤中幸存下来，强调要警惕脑积水。
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