Management of a traumatic avulsion fracture of the occipital condyle in polytrauma patient in Korea: a case report
Avulsion fracture of the occipital condyle are rare lesion at craniovertebral junction. It is often related to high-energy traumatic injuries and show diverse clinical presentations. Neurologic deficit and instabilities may justify surgical treatment. However, the integrity of neurovascular structur...
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Korean Society of Traumatology
2023-06-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://jtraumainj.org/upload/pdf/jti-2022-0058.pdf |
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| author | Chang Hwa Ham Woo-Keun Kwon Joo Han Kim Youn-Kwan Park Jong Hyun Kim |
| author_facet | Chang Hwa Ham Woo-Keun Kwon Joo Han Kim Youn-Kwan Park Jong Hyun Kim |
| author_sort | Chang Hwa Ham |
| collection | DOAJ |
| description | Avulsion fracture of the occipital condyle are rare lesion at craniovertebral junction. It is often related to high-energy traumatic injuries and show diverse clinical presentations. Neurologic deficit and instabilities may justify surgical treatment. However, the integrity of neurovascular structures is undervalued in the current literatures. In this case report, we described a 26-year-old female patient with avulsion fracture of occipital condyle following a traffic accident. On initial presentation, her Glasgow Coma Scale was 8. She presented with fracture compound comminuted depressed, on the left side of her forehead with skull base fracture extending into clivus and occipital condyle. Her left occipital condyle showed avulsion injury with displacement deep into the skull base. On her computed tomography angiography, the displaced occipital condyle compressed on the sigmoid sinus resulting in its obstruction. While she was recovering her consciousness during her stay in the hospital, the lower cranial nerves showed dysfunctions corresponding to Collet-Sicard syndrome. Due to high risk of vascular injury, the patient was conservatively treated for the occipital condyle fracture. On the 4 months postdischarge follow-up, her cranial nerve symptoms practically recovered, and the occipital condyle showed signs of fusion without further displacement. Current literatures focus on neurologic deficit and stability for the surgical decisions. However, it is also important to evaluate the neurovascular integrity to assess the risk of its manipulation as it may result in fatal outcome. This case shows, an unstable avulsion occipital condyle fracture with neurologic deficit can be treated conservatively and show a favorable outcome. |
| format | Article |
| id | doaj-art-7ec2d9408e144ff6be6014019637042d |
| institution | Kabale University |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2023-06-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-7ec2d9408e144ff6be6014019637042d2025-01-16T05:39:48ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832023-06-0136214715110.20408/jti.2022.00581233Management of a traumatic avulsion fracture of the occipital condyle in polytrauma patient in Korea: a case reportChang Hwa Ham0Woo-Keun Kwon1Joo Han Kim2Youn-Kwan Park3Jong Hyun Kim4 Focused Training Center for Trauma, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, KoreaAvulsion fracture of the occipital condyle are rare lesion at craniovertebral junction. It is often related to high-energy traumatic injuries and show diverse clinical presentations. Neurologic deficit and instabilities may justify surgical treatment. However, the integrity of neurovascular structures is undervalued in the current literatures. In this case report, we described a 26-year-old female patient with avulsion fracture of occipital condyle following a traffic accident. On initial presentation, her Glasgow Coma Scale was 8. She presented with fracture compound comminuted depressed, on the left side of her forehead with skull base fracture extending into clivus and occipital condyle. Her left occipital condyle showed avulsion injury with displacement deep into the skull base. On her computed tomography angiography, the displaced occipital condyle compressed on the sigmoid sinus resulting in its obstruction. While she was recovering her consciousness during her stay in the hospital, the lower cranial nerves showed dysfunctions corresponding to Collet-Sicard syndrome. Due to high risk of vascular injury, the patient was conservatively treated for the occipital condyle fracture. On the 4 months postdischarge follow-up, her cranial nerve symptoms practically recovered, and the occipital condyle showed signs of fusion without further displacement. Current literatures focus on neurologic deficit and stability for the surgical decisions. However, it is also important to evaluate the neurovascular integrity to assess the risk of its manipulation as it may result in fatal outcome. This case shows, an unstable avulsion occipital condyle fracture with neurologic deficit can be treated conservatively and show a favorable outcome.http://jtraumainj.org/upload/pdf/jti-2022-0058.pdfoccipital condyle fractureavulsioncomputed tomography angiographycollet-sicard syndromecase reports |
| spellingShingle | Chang Hwa Ham Woo-Keun Kwon Joo Han Kim Youn-Kwan Park Jong Hyun Kim Management of a traumatic avulsion fracture of the occipital condyle in polytrauma patient in Korea: a case report Journal of Trauma and Injury occipital condyle fracture avulsion computed tomography angiography collet-sicard syndrome case reports |
| title | Management of a traumatic avulsion fracture of the occipital condyle in polytrauma patient in Korea: a case report |
| title_full | Management of a traumatic avulsion fracture of the occipital condyle in polytrauma patient in Korea: a case report |
| title_fullStr | Management of a traumatic avulsion fracture of the occipital condyle in polytrauma patient in Korea: a case report |
| title_full_unstemmed | Management of a traumatic avulsion fracture of the occipital condyle in polytrauma patient in Korea: a case report |
| title_short | Management of a traumatic avulsion fracture of the occipital condyle in polytrauma patient in Korea: a case report |
| title_sort | management of a traumatic avulsion fracture of the occipital condyle in polytrauma patient in korea a case report |
| topic | occipital condyle fracture avulsion computed tomography angiography collet-sicard syndrome case reports |
| url | http://jtraumainj.org/upload/pdf/jti-2022-0058.pdf |
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