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International Journal of Emergency Medicine

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Open Access 01-12-2014 | Case report

Occipital condyle fracture in a patient with neck pain

Authors: Muhammad Waseem, Ruchi Upadhyay, Husayn Al-Husayni, Samuel Agyare

Published in: International Journal of Emergency Medicine | Issue 1/2014

Abstract

Background

Occipital condyle fractures (OCF) are rare traumatic injuries and are of critical clinical importance because of the anatomic considerations of the occipitoatlantoaxial joint complex. OCF can be a diagnostic challenge because of the inability to diagnose this injury with plain radiographs. This is especially true in the emergency department (ED) setting. A high degree of clinical suspicion and careful investigation of the craniocervical junction is warranted in patients presenting to the ED with head and cervical trauma.

Findings

We present a case of a 45-year-old male who presented to the ED with complaints of neck pain and headache four days after an assault. The classification, clinical presentation, diagnosis, and management of his injury are discussed, and pertinent literature is reviewed.

Conclusions

OCF can be easily overlooked due to multiple factors; including the conscious state of the patient or the inability to diagnose it through plain radiographs. Early recognition and diagnosis of OCF is crucial to prevent neurological involvement.

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Bolender N, Cromwell LD, Wendling L: Fracture of the occipital condyle. AJR Am J Roentgenol 1978,131(4):729–731. 10.2214/ajr.131.4.729CrossRefPubMed

Chugh S, Kamian K, Depreitere B, Schwartz ML: Occipital condyle fracture with associated hypoglossal nerve injury. Can J Neurol Sci 2006,33(3):322–324.CrossRefPubMed

Karam YR, Traynelis VC: Occipital condyle fractures. Neurosurgery 2010,66(3 Suppl):56–59.CrossRefPubMed

Kelly A, Parrish R: Fracture of the occipital condyle: the forgotten part of the neck. J Accid Emerg Med 2000,17(3):220–221. 10.1136/emj.17.3.220PubMedCentralCrossRefPubMed

Noble ER, Smoker WR: The forgotten condyle: the appearance, morphology, and classification of occipital condyle fractures. AJNR Am J Neuroradiol 1996,17(3):507–513.PubMed

Paiva WS, Rusafa-Neto E, Amorim RL, Figueiredo EG, de Andrade AF, Teixeira MJ: Occipital condyle fracture in a patient with head trauma. Arq Neuropsiquiatr 2009,67(1):119–120. 10.1590/S0004-282X2009000100030CrossRefPubMed

Schrödel MH, Kestlmeier R, Trappe AE: Bilateral occipital condyle fracture: report of two cases. Skull Base 2002,12(2):93–96. 10.1055/s-2002-31571-1PubMedCentralCrossRefPubMed

Tuli S, Tator CH, Fehlings MG, Mackay M: Occipital condyle fractures. Neurosurgery 1997,41(2):368–376. Discussion 376–377 10.1097/00006123-199708000-00006CrossRefPubMed

Dashti R, Ulu MO, Albayram S, Aydin S, Ulusoy L, Hanci M: Concomitant fracture of bilateral occipital condyle and inferior clivus: what is the mechanism of injury? Eur Spine J 2007,16(Suppl 3):261–264.PubMedCentralCrossRefPubMed

10.

Blacksin MF, Lee HJ: Frequency and significance of fractures of the upper cervical spine detected by CT in patients with severe neck trauma. AJR Am J Roentgenol 1995,165(5):1201–1204. 10.2214/ajr.165.5.7572503CrossRefPubMed

11.

Hanson JA, Deliganis AV, Baxter AB, Cohen WA, Linnau KF, Wilson AJ, Mann FA: Radiologic and clinical spectrum of occipital condyle fractures: retrospective review of 107 consecutive fractures in 95 patients. AJR Am J Roentgenol 2002,178(5):1261–1268. 10.2214/ajr.178.5.1781261CrossRefPubMed

12.

Rao RD, Singhal P: Delayed development of neurological deficit from an occipital fracture. A case report. J Bone Joint Surg Am 2004,86-A(5):1047–1050.PubMed

13.

Tanabe M, Watanabe T, Matsumoto S, Okamoto H, Shirakashi K: Avulsion fracture of the anterior half of the foramen magnum involving the bilateral occipital condyles and the inferior clivus–case report. Neurol Med Chir (Tokyo) 1999,39(5):358–361. 10.2176/nmc.39.358CrossRef

14.

Clayman DA, Sykes CH, Vines FS: Occipital condyle fractures: clinical presentation and radiologic detection. AJNR Am J Neuroradiol 1994,15(7):1309–1315.PubMed

15.

Su TM, Lui CC, Cheng MH, Tsai SC: Occipital condyle fracture with hypoglossal nerve palsy: case report. J Trauma 2000,49(6):1144–1146. 10.1097/00005373-200012000-00032CrossRefPubMed

Title: Occipital condyle fracture in a patient with neck pain
Authors: Muhammad Waseem
Ruchi Upadhyay
Husayn Al-Husayni
Samuel Agyare
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Emergency Medicine / Issue 1/2014
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI: https://doi.org/10.1186/1865-1380-7-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Occipital condyle fracture in a patient with neck pain

Abstract

Background

Findings

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Findings

Conclusions

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