Aldamouni Maeen B, Albitar Mohammed H, Alhosainy Ziad H, Aljohani Hanan N, Alshail Essam
Department of Neurosurgery, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.
College of Medicine, Alfaisal University, Riyadh, SAU.
Cureus. 2023 Feb 17;15(2):e35128. doi: 10.7759/cureus.35128. eCollection 2023 Feb.
Grisel's syndrome (GS) is a rare neurosurgical condition involving nontraumatic rotatory subluxation of the atlantoaxial joint. This case report presents a two-month-old infant girl, the youngest reported case of this syndrome based on our literature review to the date of this publication. The infant was initially referred to our hospital as a case of the arachnoid cyst but was subsequently neuroradiologically diagnosed with GS, which was believed to be secondary to a retropharyngeal abscess. After developing weakness and developmental delay as well as failing conservative management for two years, the infant underwent C1 laminectomy and occipitocervical sublaminar wire fusion with favorable outcomes. GS should be considered a differential even if the patient does not present with typical signs such as torticollis and neck pain. If not identified early and treated effectively, it can result in severe neurological damage. The management plan largely depends on the Fielding-Hawkins grade of subluxation and the timing of diagnosis.
格里塞尔综合征（GS）是一种罕见的神经外科疾病，涉及寰枢关节非创伤性旋转半脱位。本病例报告介绍了一名两个月大的女婴，根据我们截至本出版物日期的文献综述，这是该综合征报告的最年轻病例。该婴儿最初因蛛网膜囊肿被转诊至我院，但随后经神经放射学诊断为GS，据信这是由咽后脓肿继发所致。在出现肌无力和发育迟缓以及两年保守治疗无效后，该婴儿接受了C1椎板切除术和枕颈椎板下钢丝融合术，效果良好。即使患者没有出现斜颈和颈部疼痛等典型症状，也应考虑GS作为鉴别诊断。如果不及早识别并有效治疗，可能会导致严重的神经损伤。治疗方案很大程度上取决于半脱位的菲尔丁-霍金斯分级和诊断时机。
