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John C. McNerney March 1949 6 2 169 174 10.3171/jns.1949.6.2.0169 Non-Traumatic Atlanto-Axial Dislocation Leonard A. Titrud C. A. McKinlay Walter E. Camp Hewitt B. Hannah March 1949 6 2 174 180 10.3171/jns.1949.6.2.0174 Extradural Haemorrhage as a Cause of Cortical Blindness A. N. Guthkelch March 1949 6 2 180 182 10.3171/jns.1949.6.2.0180 Meningioma of the Sphenoid Ridge in a Child Collin S. MacCarty Louis J. Gogela March 1949 6 2 182 186 10.3171/jns.1949.6.2.0182 J Neurosurg Journal of

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Non-Traumatic Atlanto-Axial Dislocation

Report of Case with Recovery after Quadriplegia

Leonard A. Titrud, C. A. McKinlay, Walter E. Camp and Hewitt B. Hannah

They emphasized the avoidance of excessive rotation and manipulation of a child's head during surgical drainage of cervical infections since the relaxed anesthetic muscles may not protect against vertebral dislocation. These same authors 9 reported in 1942 a 5-year follow-up of a 12-year-old boy who had an unreduced spontaneous atlanto-axial dislocation. Their suggestion was that although occasionally spontaneous reduction and normal calcification may occur, some of the persisting spinal deformities in older persons may have arisen as in their described case. Martin

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1957 14 1 61 67 10.3171/jns.1957.14.1.0061 A Note on the Treatment of Involuntary Movements of the Arm by Resection of the Brachial Plexus Carl J. Bridge Gilbert Horrax January 1957 14 1 68 73 10.3171/jns.1957.14.1.0068 Fatal Brain-Stem Shift Following Hemispherectomy Fernando Cabieses Raúl Jerí Rodolfo Landa January 1957 14 1 74 91 10.3171/jns.1957.14.1.0074 “Central Pain” from Cerebral Arteriovenous Aneurysm Maurice L. Silver January 1957 14 1 92 96 10.3171/jns.1957.14.1.0092 Myelopathy Caused by Atlanto-Axial

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Joseph Stratford

Injury to the upper cervical spine resulting in a separate odontoid process and atlanto-axial dislocation presents a serious problem. The patient may survive the initial episode and the injury may remain undetected and untreated. A sudden recurrence of the deformity may produce signs of damage to the spinal cord, or, over a period of many months or years, evidence of cord damage may slowly develop as the result of recurrent gliding of the atlas on the axis, with consequent narrowing of the vertebral canal. Corner, 6 in 1907, describing a series of patients

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Dislocation of the Atlas on the Axis

The Value of Early Fusion of C1, C2, and C3

Eben Alexander Jr., H. F. Forsyth, C. H. Davis Jr. and Blaine S. Nashold Jr.

described. This proved satisfactory in 12 patients seen over a number of years. 8. Experience gained from this relatively large group of surgically treated patients, all carefully followed postoperatively, leads to the conclusion that early surgical fusion in cases of fracture of the odontoid process protects the patient from the late sequelae of atlanto-axial dislocation. Fusion can be done with much shorter hospitalization and earlier return to useful employment than with prolonged traction and immobilization which does not assure solid healing of the fractured

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A. E. Carter

lessened and amid some struggling the dura mater expanded spontaneously. Postoperatively consciousness was regained completely within 48 hours and all abnormal neurological signs disappeared in 7 days, the right plantar response being the last to return to normal. The child's subsequent recovery was uneventful until he was killed in a traffic accident on Jan. 14, 1958. Postmortem examination disclosed no abnormalities within the cranium, the defect from the operation being the only defect. Death was caused by atlanto-axial dislocation. On further questioning the

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H. M. Askenasy, J. Braham and I. Z. Kosary

Traumatic atlanto-axial fracture with dislocation of the odontoid process results in most cases in immediate quadriplegia and has a high mortality. In a few instances, however, neurological complications are slight or not apparent and the fracture dislocation is not suspected at the time. The late onset of a syndrome compatible with spinal myelopathy could then present diagnostic problems in which an underlying lesion of this nature might not be suspected; this would of course be particularly likely if a period of years separated the trauma and the emergence of

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Ventricle J. Grafton Love Robert J. White November 1960 17 6 1083 1088 10.3171/jns.1960.17.6.1083 Extradural Hematoma of the Anterior Fossa Keith Whittaker November 1960 17 6 1089 1092 10.3171/jns.1960.17.6.1089 Dystonia Musculorum Deformans Alleviated by Chemopallidothalamectomy and Substantia Nigralysis Robert W. Rand November 1960 17 6 1093 1099 10.3171/jns.1960.17.6.1093 Delayed Spinal Myelopathy Following Atlanto-Axial Fracture Dislocation H. M. Askenasy J. Braham I. Z. Kosary November 1960 17 6 1100

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Vertebral Artery Insufficiency in Acute and Chronic Spinal Trauma

With Special Reference to the Syndrome of Acute Central Cervical Spinal Cord Injury

Richard C. Schneider and George W. Schemm

arteries might be compressed simultaneously at three main sites: a) Any fracture-dislocation of the cervical spine above the C6 intervertebral foramen may cause compression of the vessels at the displaced intervertebral foramina. b) Atlantoaxial dislocation will cause compression at the C1 intervertebral foramina. c) Atlantoaxial dislocation may cause compression at the point where the occipital condyle slides forward over the well indented groove in the lamina of the first cervical vertebra. With bilateral spasm or compression of the vertebral artery, a relative

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Charles G. Drake

myelopathy is based upon evidence that the vertebral artery may be compressed by cervical subluxation at the atlanto-occipital and atlantoaxial junctions as well as below, particularly where unco-vertebral lipping narrows the canal of the vertebral artery. The secondary relative insufficiency in the anterior spinal and anterior sulcal arteries produces the central softening. As the leg area of the corticospinal tracts, the posterior columns and the lateral spinothalamic tracts lie more peripherally and are nourished by the arteriae coronae (branches of the posterior spinal