Atlantooccipital dislocation (atlanto-occipital dislocation), also known as internal decapitation describes the separation of the skull from C1 and C2 vertebrae due to severe cervico-cranial injury. Associated facial and head injuries are common.
Reports of adult AOD have been commonly described in front-end motor vehicle collisions with unbelted occupants and airbag interactions. It may be a devastating condition that may result in sudden cardiorespiratory arrest and accounts for 15% of fatal spinal trauma. It occurs 5 times more commonly in children than adults. Neurologic injury is usually severe secondary to ligamentous disruption. Cranial nerve deficits are common among survivors.

There are several methods described to diagnose this injury:
  • Occipital Condyle-C1 Interval
  • Powers Ratio
  • Lee X-Line
  • Wholey Dens-Basion Line
  • Dublin Method
  • Harris Basion-Axis Interval
  • Sun Interspinous Ratio
  • Condylar Sum

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