![]() ![]() The reason that being upright is problematic is that gravity allows increased interaction between the brain stem and the top of the spinal column, increasing symptoms. Symptoms are frequently worsened by a Valsalva maneuver, or by being upright for long periods of time. Dysphagia, or the sensation of being choked.Bobble-head doll syndrome, a sensation that the skull may fall off the cervical spine.The constellation of symptoms caused by craniocervical instability is known as "cervico-medullary syndrome" and includes: The impact of craniocervical instability can range from minor symptoms to severe disability in which patients are bed-bound. The condition can be brought on by physical trauma, including whiplash, laxity of the ligaments surrounding the joint, or other damage to the surrounding connective tissue. It is frequently co-morbid with atlanto-axial joint instability, Chiari malformation, or tethered spinal cord syndrome. The condition can cause neural injury and compression of nearby structures, including the brain stem, spinal cord, vagus nerve, and vertebral artery, resulting in a constellation of symptoms.Ĭraniocervical instability is more common in people with a connective tissue disease, including Ehlers-Danlos syndromes, osteogenesis imperfecta, and rheumatoid arthritis. Upper extremity deficit is greater than lower extremity deficit, because the lower extremity corticospinal tracts are located lateral in the cord.Medical condition affecting the cervical spineĬraniocervical instability ( CCI) is a medical condition characterized by excessive movement of the vertebra at the atlanto-occipital joint and the atlanto-axial joint located between the skull and the top two vertebra, known as C1 and C2.Frequently found in elderly with underlying spondylosis or younger people with severe extension injury (figure).It is unstable and is associated with a high incidence of cord damage. Flexion teardrop farcture is the result of extreme flection with axial loading.BID is unstable and is associated with a high incidence of cord damage. Bilateral interfacet dislocation is the result of extreme flection.Unilateral interfacet dislocation is due to both flexion and rotation.Unstable wedge fracture is an unstable flexion injury due to damage to both the anterior column (anterior wedge fracture) as the posterior column (interspinous ligament).Increased concavity along with increased density due to bony impaction. Simple wedge fracture is the result of a pure flexion injury.Since the anterior and middle columns remain intact, this fracture is stable. Anterior subluxation occurs when the posterior ligaments rupture.The most common fracture mechanism in cervical injuries is hyperflexion. Hyperextension with superimposed spondylosis.You can click on some of the images to get a larger image. In this overview we will discuss the most common cervical spine injuries. One third of injuries occur at the level of C2, and one half of injuries occur at the level of C6 or C7. Most cervical spine fractures occur predominantly at two levels. Up to 17% of patients have a missed or delayed diagnosis of cervical spine injury, with a risk of permanent neurologic deficit after missed injury of 29%. This review is based on a presentation given by Adam Flanders and adapted for the Radiology Assistant by Robin Smithuis.Īpproximately 3 % of patients who present to the emergency department as the result of a motor vehicle accident or fall have a major injury to the cervical spine.ġ0-20% patients with head injury also have a cervical spine injury. How to Differentiate Carotid Obstructions.Ankle fractures - Weber and Lauge-Hansen Classification.Ankle Fracture Mechanism and Radiography.TI-RADS - Thyroid Imaging Reporting and Data System.Head Neck tumors - When to think of malignancy.Anatomy and Pathology of the Infrahyoid Neck.Esophagus II: Strictures, Acute syndromes, Neoplasms and Vascular impressions.Pulmonary nodule - Benign versus Malignant.Mediastinal Masses - differential diagnosis.Esophagus I: anatomy, rings, inflammation.Vascular Anomalies of Aorta, Pulmonary and Systemic vessels.Contrast-enhanced MRA of peripheral vessels.Ischemic and non-ischemic cardiomyopathy.Coronary Artery Disease-Reporting and Data System 2.0.Bi-RADS for Mammography and Ultrasound 2013.Transvaginal Ultrasound for Non-Gynaecological Conditions.Acute Abdomen in Gynaecology - Ultrasound.Appendicitis - Pitfalls in US and CT diagnosis. ![]()
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