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Occipital condyle fracture and lower cranial nerve palsy after blunt head trauma – a literature review and case report

BACKGROUND: Lower cranial nerve (IX-XII) palsy is a rare condition with numerous causes, usually non-traumatic. In the literature it has been described only a few times after trauma, mostly accompanied by a fracture of the occipital condyle. Although these types of fractures have rarely been reporte...

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Autores principales: Utheim, Nils Christian, Josefsen, Roger, Nakstad, Per Hjalmar, Solgaard, Torfinn, Roise, Olav
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4403883/
https://www.ncbi.nlm.nih.gov/pubmed/25897322
http://dx.doi.org/10.1186/s13032-015-0024-3
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author Utheim, Nils Christian
Josefsen, Roger
Nakstad, Per Hjalmar
Solgaard, Torfinn
Roise, Olav
author_facet Utheim, Nils Christian
Josefsen, Roger
Nakstad, Per Hjalmar
Solgaard, Torfinn
Roise, Olav
author_sort Utheim, Nils Christian
collection PubMed
description BACKGROUND: Lower cranial nerve (IX-XII) palsy is a rare condition with numerous causes, usually non-traumatic. In the literature it has been described only a few times after trauma, mostly accompanied by a fracture of the occipital condyle. Although these types of fractures have rarely been reported one could suspect they have been under-diagnosed. During the past decade they have been seen more frequently, most probably due to increased use of CT- and MRI-scanning. The purpose of this review is to increase the awareness of complications following injuries in the craniocervical region. METHODS: We based this article on a retrospective review of the medical record of a 24-year old woman admitted to our trauma center after being involved in a car accident and a review of the literature on occipital condyle fractures associated with lower cranial nerve palsy. RESULTS: The multitraumatized patient had suffered a dislocated occipital condyle fracture. Months later she was diagnosed with palsy to cranial nerve IX-XII. Literature review shows that occipital condyle fractures are rare as isolated injuries and are in many cases accompanied by further injuries to the cervical spine and soft tissue structures, in many cases ending with severe disability. The exact mechanism leading to these injuries cannot always be explained. CONCLUSION: Recognition of soft tissue injuries in patients with blunt head trauma is important. CT findings involving the craniocervical junction in these patients advocates further investigations including a thorough neurological examination and liberal use of MRI.
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spelling pubmed-44038832015-04-21 Occipital condyle fracture and lower cranial nerve palsy after blunt head trauma – a literature review and case report Utheim, Nils Christian Josefsen, Roger Nakstad, Per Hjalmar Solgaard, Torfinn Roise, Olav J Trauma Manag Outcomes Review BACKGROUND: Lower cranial nerve (IX-XII) palsy is a rare condition with numerous causes, usually non-traumatic. In the literature it has been described only a few times after trauma, mostly accompanied by a fracture of the occipital condyle. Although these types of fractures have rarely been reported one could suspect they have been under-diagnosed. During the past decade they have been seen more frequently, most probably due to increased use of CT- and MRI-scanning. The purpose of this review is to increase the awareness of complications following injuries in the craniocervical region. METHODS: We based this article on a retrospective review of the medical record of a 24-year old woman admitted to our trauma center after being involved in a car accident and a review of the literature on occipital condyle fractures associated with lower cranial nerve palsy. RESULTS: The multitraumatized patient had suffered a dislocated occipital condyle fracture. Months later she was diagnosed with palsy to cranial nerve IX-XII. Literature review shows that occipital condyle fractures are rare as isolated injuries and are in many cases accompanied by further injuries to the cervical spine and soft tissue structures, in many cases ending with severe disability. The exact mechanism leading to these injuries cannot always be explained. CONCLUSION: Recognition of soft tissue injuries in patients with blunt head trauma is important. CT findings involving the craniocervical junction in these patients advocates further investigations including a thorough neurological examination and liberal use of MRI. BioMed Central 2015-04-11 /pmc/articles/PMC4403883/ /pubmed/25897322 http://dx.doi.org/10.1186/s13032-015-0024-3 Text en © Utheim et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Utheim, Nils Christian
Josefsen, Roger
Nakstad, Per Hjalmar
Solgaard, Torfinn
Roise, Olav
Occipital condyle fracture and lower cranial nerve palsy after blunt head trauma – a literature review and case report
title Occipital condyle fracture and lower cranial nerve palsy after blunt head trauma – a literature review and case report
title_full Occipital condyle fracture and lower cranial nerve palsy after blunt head trauma – a literature review and case report
title_fullStr Occipital condyle fracture and lower cranial nerve palsy after blunt head trauma – a literature review and case report
title_full_unstemmed Occipital condyle fracture and lower cranial nerve palsy after blunt head trauma – a literature review and case report
title_short Occipital condyle fracture and lower cranial nerve palsy after blunt head trauma – a literature review and case report
title_sort occipital condyle fracture and lower cranial nerve palsy after blunt head trauma – a literature review and case report
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4403883/
https://www.ncbi.nlm.nih.gov/pubmed/25897322
http://dx.doi.org/10.1186/s13032-015-0024-3
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