Atlanto-Axial Dislocation -Report of Three Cases
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概要
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Presenting three cases of children, the authors discussed the atlanto-axial dislocation from etiolog ical, symptomatological, roentgenographical and therapeutic viewpoints.<BR>Case 1, a 15-year-old boy, showed a slight limping already at the age of 2. The limping slowly progressed later on, and had developed into nearly a complete right hemiplegia by the age of 13. A left hemihypesthesia became evident as the motor weakness progressed. X-ray studies demonstrated a basilar impression and other malformations around the foramen magnum as well as an abnormal anterior dislocation of the atlas upon anterior flexion of the neck. A suboccipital craniectomy including upper cervical laminectomy and dural plasty was performed for decompression of the neural elements.<BR>Case 2, a girl aged 2 years and 11 months, was admitted with complaints of progressive gait distur bance and neck pain of three months' duration. On admission, the bilateral lower and left upper extremities were markedly weak. There was positive Babinski sign on the left. Roentgenogram showed a considerable atlanto-axial dislocation associated with a hypoplasia of the odontoid process. Fixation and fusion of the occipital bone, atlas and axis were attempted with a bone graft and wire.<BR>Case 3, a boy of 15 years, was a single child of parents with consanguinity of cousins, and had a history of multiple pathological fractures of the extremities. X-ray films of the long bones suggested osteopoikilosis. Just before admission, he had a sudden and transient quadriplegia and dysesthesia throughout the body, when his head was pushed forward. Cervical films showed a separation of the apical portion of the odontoid process and a marked anterior dislocation of the atlas on neck flexion. A high collar was applied and he has been doing well until the present.
- 一般社団法人 日本小児神経学会の論文
一般社団法人 日本小児神経学会 | 論文
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