Occipital condyle fracture and lower cranial nerve palsy after blunt head trauma – a literature review and case report

Journal of Trauma Management & Outcomes

Olav Roise²  Torfinn Solgaard¹  Per Hjalmar Nakstad²  Roger Josefsen¹  Nils Christian Utheim¹ 

[1] Department of Neurosurgery, Division of Surgery and Neuroscience, Oslo University Hospital, Oslo, Norway;Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway

关键词: Collet-Sicard-Syndrome;    Occipital condyle fracture;    Cranial nerve palsy;   

Others  :  1204148
DOI  :  10.1186/s13032-015-0024-3

 received in 2014-02-18, accepted in 2015-03-13,  发布年份 2015

【 摘 要 】

Background

Lower cranial nerve (IX-XII) palsy is a rare condition with numerous causes, usually non-traumatic. In the literature it has been described only a few times after trauma, mostly accompanied by a fracture of the occipital condyle. Although these types of fractures have rarely been reported one could suspect they have been under-diagnosed. During the past decade they have been seen more frequently, most probably due to increased use of CT- and MRI-scanning. The purpose of this review is to increase the awareness of complications following injuries in the craniocervical region.

Methods

We based this article on a retrospective review of the medical record of a 24-year old woman admitted to our trauma center after being involved in a car accident and a review of the literature on occipital condyle fractures associated with lower cranial nerve palsy.

Results

The multitraumatized patient had suffered a dislocated occipital condyle fracture. Months later she was diagnosed with palsy to cranial nerve IX-XII. Literature review shows that occipital condyle fractures are rare as isolated injuries and are in many cases accompanied by further injuries to the cervical spine and soft tissue structures, in many cases ending with severe disability. The exact mechanism leading to these injuries cannot always be explained.

Conclusion

Recognition of soft tissue injuries in patients with blunt head trauma is important. CT findings involving the craniocervical junction in these patients advocates further investigations including a thorough neurological examination and liberal use of MRI.

【 授权许可】

   
2015 Utheim et al.; licensee BioMed Central.

【 图 表 】

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