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Head dislocations: causes, symptoms, diagnosis, treatment
Medical expert of the article
Last reviewed: 07.07.2025
Dislocations of the atlanto-occipital joint, or "head dislocations", are almost never encountered in clinical practice, as they usually result in the immediate death of the victim. V. P. Selivanov (1966) reported on the preservation of the life of a victim treated for a subluxation of the atlanto-occipital joint.
Subluxations, dislocations, fracture-dislocations are the most common type of injury to the cervical spine. Fractures of the cervical vertebrae without partial or complete displacement of the damaged vertebrae relative to each other are much less common. Quite often, dislocations of the cervical vertebrae are combined with fractures of various elements of the displaced vertebrae - in these cases, it is more correct to speak of fracture-dislocations.
The anatomical and functional features of the two upper cervical vertebrae determine the characteristics of injuries encountered in this area.
Injuries to the two upper cervical vertebrae occupy a special place among injuries to the cervical spine. Between the occipital bone and the atlas, as well as between the atlas and axis, there are no shock absorbers in the form of intervertebral discs that would be able to soften the force of impact that occurs when violence is applied. Only the lateral sections of the atlas - the lateral masses - are able to withstand violence, because the arches of the atlas are thin and do not have a sufficient margin of safety. At the level of the upper cervical vertebrae, the spinal canal is wide enough, and displacements between the atlas and axis within 4-5 mm may not be accompanied by neurological disorders. However, despite the sufficient reserve spaces in this area, in case of injuries to the upper cervical vertebrae, the spinal cord is often involved.
Where does it hurt?
Diagnosis of head dislocation
This injury occurs as a result of massive trauma and is usually associated with severe brain damage. The basis for a reliable diagnosis is spondylography. The presence of displacement of the articulating surfaces of the occipital bone with the atlas confirms the presumed clinical diagnosis.
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What do need to examine?
How to examine?
Treatment of head dislocation
Treatment of head dislocation is limited to bringing the patient out of a serious condition and, apparently, in most cases should involve resuscitation.
Special treatment for head dislocation consists of reduction and immobilization. The main method of reduction is traction of the cranial vault bones. If the acute period is successful, subsequent long-term immobilization is necessary for many months.