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A case of atlantoaxial dislocation associated with ipsilateral vertebral and carotid artery dissections: highlighting the injury biomechanics and management strategy

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Abstract

Introduction

Traumatic cervical artery dissections carry significant morbidity and mortality among blunt trauma victims. The current paper illustrates a case with a young male who presented with atlantoaxial dislocation associated with ipsilateral carotid and vertebral artery dissections complicated by middle cerebral artery (MCA) infarction.

Case Report

We report a young male who presented to the emergency department with ipsilateral carotid and vertebral artery dissections complicated by middle cerebral artery (MCA) stroke associated with atlantoaxial dislocation after jumping into the water from a height. A young patient presented to us 1 year after sustaining an injury. We did posterior C1/2 fusion using the technique described by Harms and Goel to treat his atlantoaxial dislocation. The patient tolerated the surgery well and was discharged on postoperative day 4.

Conclusions

We highlighted the complicated course of the simultaneously traumatic dissections of ipsilateral cervical arteries along with atlantoaxial dislocation, the biomechanics of this combination of injuries, and their management strategy.

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Abbreviations

TCAD:

Traumatic cervical artery dissections

IONM:

Intraoperative neuromonitoring

SEPs:

Somatosensory-evoked potentials

tcMEPs:

Transcranial motor-evoked potentials

MCA:

Middle cerebral artery

AAD:

Atlantoaxial dislocation

References

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Ankara City Hospital, Ankara, Turkey

    Azad Malikov, Ahmet Eren Secen & Ali Dalgic

Authors
  1. Azad Malikov
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  2. Ahmet Eren Secen
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  3. Ali Dalgic
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Corresponding author

Correspondence to Azad Malikov.

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Ethical approval was not sought for this case report as it was not required due to the nature of the case report.

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Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for the review of the Editor-in-Chief of this journal on request.

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There were no conflicts of interest during the writing or submission of this article.

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Malikov, A., Secen, A.E. & Dalgic, A. A case of atlantoaxial dislocation associated with ipsilateral vertebral and carotid artery dissections: highlighting the injury biomechanics and management strategy. Childs Nerv Syst 38, 2231–2234 (2022). https://doi.org/10.1007/s00381-022-05549-w

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  • DOI: https://doi.org/10.1007/s00381-022-05549-w

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