title: Homicide by manual occipitoatlantal dislocation.
abstract: Occipitoatlantal dislocation is usually seen as a fatal injury in traffic accidents and has rarely been reported as a consequence of a homicide. The authors report the case of a women presenting a fatal occipitoatlantal dislocation, the circumstances of which pointed to a homicidal origin. Blood extravasation surrounding the muscles of the posterior part of the neck as well as abnormal mobility of the cranio-cervical joint was noted during autopsy; thus a complete dissection of this region was performed. This led to the finding of a fracture of the left occipital condyle and of the left superior articular facet of the atlas. This case clearly demonstrates the need to perform a large, systematic, posterior approach to the upper cervical spine, completed by the opening of the skull around the posterior fossa, when injury to the cranio-cervical junction is suspected. In these cases, the classic anterior approach give poor information and poor dissection possibilities.
authors.affiliation: Institut de Medecine Legale-11, rue Humann, F-67085 Strasbourg, France. Jean-Sebastien.Raul@iml-ulp.u-strasbg.fr
authors.forename: Jean-Sébastien
authors.initials: JS
authors.lastname: Raul
authors.forename: Antoine
authors.initials: A
authors.lastname: Tracqui
authors.forename: Bertrand
authors.initials: B
authors.lastname: Ludes
mesh_terms: D000328:Adult; D001269:Atlanto-Occipital Joint / Q000293:injuries*; D020203:Brain Stem Hemorrhage, Traumatic / Q000473:pathology; D005260:Female; D006708:Homicide; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology* / Q000473:pathology; D008722:Methods