Traumatic atlanto-occipital dissociation presenting as locked-in syndrome

Rupen Desai, Merritt D. Kinon, Daniel B. Loriaux, Carlos A. Bagley

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


We present an unusual presentation of unstable atlanto-occipital dissociation as locked-in syndrome. Traumatic atlanto-occipital dissociation is a severe injury that accounts for 15-20% of all fatal cervical spinal injuries. A disruption occurs between the tectorial ligaments connecting the occipital condyle to the superior articulating facets of the atlas, resulting in anterior, longitudinal, or posterior translation, and it may be associated with Type III odontoid fractures. Furthermore, the dissociation may be complete (atlanto-occipital dislocation) or incomplete (atlanto-occipital subluxation), with neurologic findings ranging from normal to complete quadriplegia with respiratory compromise.

Original languageEnglish (US)
Pages (from-to)1985-1987
Number of pages3
JournalJournal of Clinical Neuroscience
Issue number12
StatePublished - Dec 2015
Externally publishedYes


  • Atlanto-occipital dissociation
  • Cervical spine trauma
  • Locked-in syndrome

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)


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