title: Traumatic atlanto-occipital dislocation: do children and adolescents have better or worse outcomes than adults? A narrative review.
abstract: BACKGROUND
  Traumatic atlanto-occipital dislocation is an uncommon, severely unstable pathology, which can lead to detrimental or even fatal neurological impairment. Specifically, children have consistently been reported to be more susceptible to this type of injury because of their disproportionately larger head, ligament laxity, and injury mechanisms. However, to date, rates of missed injury and outcomes including neurologic recovery of pediatric and adult populations following this insult have not been comparatively evaluated.
  
  
  METHODS
  Standard search engines were used to investigate outcomes of traumatic atlanto-occipital dislocation in children and adolescents compared to adults.
  
  
  CONCLUSIONS
  Based on case reports and small series from the literature, it seems that children and adolescents tend to have a better likelihood of survival with the possibility of long-term neurological complications. Comparatively, adults who suffer traumatic atlanto-occipital dislocation either succumb to their injuries or survive with very little if any neurological complications.
authors.affiliation: Seattle Science Foundation, Seattle, WA, USA. shane.tubbs@childrensal.org.|Department of Anatomical Sciences, St. George's University, St. George's, Grenada. shane.tubbs@childrensal.org.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.affiliation: Department of Anatomical Sciences, St. George's University, St. George's, Grenada.
authors.forename: Chirag
authors.initials: C
authors.lastname: Patel
authors.affiliation: Department of Anatomical Sciences, St. George's University, St. George's, Grenada.
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
authors.affiliation: Swedish Neuroscience Institute, Seattle, WA, USA.
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Oskouian
authors.affiliation: Swedish Neuroscience Institute, Seattle, WA, USA.
authors.forename: Jens R
authors.initials: JR
authors.lastname: Chapman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001269:Atlanto-Occipital Joint / Q000293:injuries* / Q000473:pathology*; D002648:Child; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000175:diagnosis*; D009422:Nervous System Diseases / Q000209:etiology
keywords: Dislocation; Internal decapitation; Spinal cord injury; Trauma