title: Post-mortem CT evaluation of atlanto-occipital dissociation.
abstract: Atlanto-occipital dissociation injury is an important injury in forensic pathology practice. Radiological diagnosis of atlanto-occipital dissociation clinically is assessed by direct measurement of occipito-vertebral skeletal relationships. Different measurements may be used to diagnose atlanto-occipital dissociation, including the basion-dens interval (BDI) and basion-axial interval (BAI). It is not known whether the normal ante-mortem measurements of BDI and BAI described in the literature are applicable to post-mortem CT images of the occipito-cervical junction (OCJ) or whether these measurements could be affected by early post-mortem changes. This study aims to compare post-mortem BDI and BAI measurements with ante-mortem values. Post-mortem CT scans of the cervical spines of 100 deceased adults were reviewed, and the BDI and BAI were measured. Different parameters were recorded in each case. The results from this study suggest that there are no effects of post-mortem changes on the measurement of BAI as relied upon clinically. There appear to be some effects of fully established rigor mortis on BDI measurement, shortening it. This may have consequences for the post mortem diagnosis of atlanto-occipital dissociation.
authors.affiliation: University of Dammam, Saudi Arabia; Victorian Institute of Forensic Medicine, Australia. Electronic address: mmadadin@uod.edu.sa.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Madadin
authors.affiliation: Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Sri Lanka.
authors.forename: Ravindra Priyalal
authors.initials: RP
authors.lastname: Samaranayake
authors.affiliation: Victorian Institute of Forensic Medicine, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: O'Donnell
authors.affiliation: Victorian Institute of Forensic Medicine, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Cordner
mesh_terms: D000328:Adult; D001269:Atlanto-Occipital Joint / Q000000981:diagnostic imaging* / Q000293:injuries*; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011180:Postmortem Changes; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Atlanto-occipital dissociation; Post-mortem CT