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Dislocations of the head: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Dislocations in the atlanto-occipital articulation, or "dislocations of the head," almost never occur in clinical practice, since they usually lead to the immediate death of the victim. VP Selivanov (1966) reported on the preservation of life to the victim, who was treated for subluxation in the atlanto-occipital articulation.
Subluxations, dislocations, fracture-dislocations are the most common type of trauma in the cervical spine. Fractures of the cervical vertebrae without partial or complete displacement of the damaged vertebrae relative to each other are much less common. Very often dislocations of cervical vertebrae are combined with fractures of various elements of displaced vertebrae - in these cases it is more correct to talk about fracture-dislocations.
From the anatomical and functional characteristics of the two upper cervical vertebrae, the features of the damage encountered in this area follow.
Damage of the two upper cervical vertebrae takes a special place among the injuries of the cervical spine. Between the occipital bone and the atlas, as well as between the atlas and the axis, there are no shock absorbers in the form of intervertebral discs, which would be able to soften the impact force arising from the violence. Only the side sections of the atlant - the lateral masses - are able to withstand violence, because the atlant's arches are thin and do not have sufficient margin of safety. At the level of the upper cervical vertebrae, the vertebral canal has a sufficient width, and displacements between the atlas and the axis within 4-5 mm may not be accompanied by neurological disorders. However, despite sufficient reserve spaces of this area, with injuries of the upper cervical vertebrae, the spinal cord is often interested.
Where does it hurt?
Diagnosis of dislocation of the head
This damage is caused by the action of massive trauma and, as a rule, is combined with severe brain damage. The basis for a reliable diagnosis is spondylography. The presence of displacement of the articulating surfaces of the occipital bone with the atlas confirms the alleged clinical diagnosis.
What do need to examine?
How to examine?
Treatment of dislocation of the head
Treatment of dislocation of the head is reduced to removing the patient from a serious condition and, apparently, in most cases should be resuscitation.
A special treatment for dislocation of the head is to correct and immobilize. The main method of correction is the stretching behind the bones of the cranial vault. With a favorable outcome of an acute period, subsequent prolonged immobilization is necessary for many months.