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BRAIN and NERVE Volume 59, Issue 10 （October 2007）

BRAIN and NERVE 59巻10号（2007年10月発行）

Japanese English

症例報告

脊椎前腔血腫による気道緊急と環椎後頭骨脱臼を呈した1生存症例 Prevertebral Hematoma and Traumatic Atlantooccipital Dislocation with Survival―Case Report 竹内誠 ¹ , 加藤宏 ² , 松崎英剛 ³ , 高里良男 ¹ , 正岡博幸 ¹ , 早川隆宣 ¹ , 大谷直樹 ¹ , 吉野義一 ¹ , 八ツ繁寛 ¹ Satoru Takeuchi ¹ , Hiroshi Kato ² , Hidetake Matsuzaki ³ , Yoshio Takasato ¹ , Hiroyuki Masaoka ¹ , Takanori Hayakawa ¹ , Naoki Otani ¹ , Yoshikazu Yoshino ¹ , Hiroshi Yatsushige ¹ ¹独立行政法人国立病院機構災害医療センター脳神経外科 ²独立行政法人国立病院機構災害医療センター救急救命センター ³独立行政法人国立病院機構災害医療センター整形外科 ¹Department of Neurosurgery, National Hospital Organization Disaster Medical Center ²Department of Emergency Medicine, National Hospital Organization Disaster Medical Center ³Department of Orthopaedic Surgery, National Hospital Organization Disaster Medical Center キーワード： atlantooccipital dislocation , trauma , posterior occipitocervical fusion , retropharyngeal hematoma Keyword: atlantooccipital dislocation , trauma , posterior occipitocervical fusion , retropharyngeal hematoma pp.1211-1214

発行日 2007年10月1日 Published Date 2007/10/1

DOI https://doi.org/10.11477/mf.1416100163

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Abstract 文献概要
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参考文献 Reference

はじめに

　頸部外傷では，脊椎前腔血腫により気道閉塞をきたす恐れがある。また，環椎後頭骨脱臼（atrantooccipital dislocation；以下AOD）はその多くが致死的で，長期生存例は稀である。今回われわれは，緊急気道確保を要する高度な脊椎前腔血腫を伴ったAODの1生存例を経験したので，文献的考察を加えて報告する。

Abstract

　Traumatic atlantooccipital dislocation is usually fatal.　Few case reports surviving this injury appeared in the literature.

　We report a rare case of a retropharyngeal hematoma and an atlantooccipital dislocation with survival.　A 31-year-old male fell from a motorcycle and was thrown.　His neurological examination showed mild weakness (gr III) and numbness of the arms.　Enlargement of retropharyngeal space on the lateral cervical radiography helped to recognize the diagnosis.　The BAI-BDI method proposed by Harris et al.　were useful for diagnosis.　Additional imaging, including CT and MRI, was helpful.　He was diagnosed atolantooccipital dislocation, retropharyngeal hematoma, cervical subdural hematoma, traumatic subarachnoid hemorrhage, and mandibular fracture.　He was orally intubated and the Philadelphia cervical collar was replaced.　Additionally, occipitocervical fusion with internal fixation was performed.

　We emphasize that the presence of retropharyngeal hematoma leads us to perform airway interventions and to suspect the presence of the upper cervical spine injury including atlantooccipital dislocation.