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Bilateral occipital condyle fractures leading to retropharyngeal haematoma and acute respiratory distress

Injuries to the occipito-cervical junction are rare and not easily diagnosed on conventional radiographs. The authors report such a case where the diagnosis was delayed. The patient developed a significant retrophyarngeal haematoma resulting in acute respiratory distress and required emergency endotracheal intubation. The patient remained intubated for five days and received a tapered dose of intravenous dexamethazone to reduce swelling in the proximity of the airway. At six weeks the patient had developed a left hypoglossal nerve palsy that persisted at 12 months. Occipital condyle fractures and the difficulties of diagnosis are discussed. The importance of measuring pre-vertebral soft tissue swelling on lateral radiographs is emphasized. Computed tomography of the C0-C2 region should be performed to identify base of skull and upper cervical fractures

Keywords : Accidents,Acute Disease,Adult,Athletic Injuries,Cervical Vertebrae,complications,diagnosis,diagnostic imaging,etiology,Hematoma,Humans,Hypoglossal Nerve Diseases,injuries,Male,Motorcycles,Occipital Bone,Pharynx,Radiography,Respiratory Distress Syndrome,Adult,Skull,Skull Fractures,surgery,therapy,Treatment Outcome,Universities,, Occipital,Condyle,Fractures,Leading, pinched nerve specialist

Date of Publication : 2005 Jan

Authors : Freeman BJ;Behensky H;

Organisation : The Centre for Spinal Studies and Surgery, University Hospital, Queens Medical Centre, Nottingham NG7 2UH, UK. brian.freeman@mail.qmcuh-tr.trent.nhs.uk

Journal of Publication : Injury

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/15589943

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