title: Infection-related atlantoaxial subluxation in two adults: Grisel syndrome or not?
abstract: Grisel's syndrome involves the subluxation of the atlanto-axial joint from inflammatory ligamantous laxity following an infectious process in the head or neck. It is a rare disease usually affecting children, but infrequent adult cases do occur. Today, due to the widened use of antibiotics and availability of MR imaging, some cases presenting with neck pain, resulting from the infectious inflammation of C1 and C2 but without pronounced subluxation, can be a challenging problem for most neurosurgeons. Several theories have been proposed to explain the pathogenesis of inflammatory subluxation. The primary treatment of Grisel's syndrome is medical. The underlying infectious organism must be isolated and appropriate antibiotics must be prescribed. The subluxation is reduced in holter or skeletal traction. This paper reports two cases of infection-related atlanto-axial subluxation in two adults. The literature on this subject is briefly reviewed.
authors.affiliation: The University of Ankara, Faculty of Medicine, Department of Neurosurgery, Turkey.
authors.forename: H C
authors.initials: HC
authors.lastname: Ugur
authors.forename: S
authors.initials: S
authors.lastname: Cağlar
authors.forename: A
authors.initials: A
authors.lastname: Unlu
authors.forename: A
authors.initials: A
authors.lastname: Erdem
authors.forename: Y
authors.initials: Y
authors.lastname: Kanpolat
mesh_terms: D000328:Adult; D000368:Aged; D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D004204:Joint Dislocations / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D013577:Syndrome; D014057:Tomography, X-Ray Computed