Understanding Atlanto-Occipital Dissociation: A Neuroradiology Case Study

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Atlanto-Occipital Dissociation (AOD) is a severe injury resulting from high-velocity trauma, with a high mortality rate. This case study from the American Society of Neuroradiology explores the mechanisms, imaging findings, and differential diagnosis of AOD, emphasizing the importance of prompt recognition and appropriate management to improve patient outcomes.


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  1. History: Trauma #ASNRCOTW American Society of Neuroradiology Courtesy of Dr. Jennifer McCarty, UT Houston ASNR Case of the Week | @theASNR

  2. Atlanto-Occipital Dissociation (AOD) Mechanism: High velocity trauma w/ distraction type injury Mortality: A reported 90% of patients w/ AOD injuries die, 60% at the scene. Three Types: I Ventral dislocation, most common II Longitudinal distraction, most unstable III Dorsal dislocation Imaging Findings on CT Basion-dens interval > 10 mm in adults Atlanto-occipital interval > 2 mm Condylar Sum > 4.2 mm, most sensitive CT sign Ligamentous disruption may involve any of the craniocervical junction ligaments, but the most important stabilizers are: Tectorial membrane Alar ligaments #ASNRCOTW American Society of Neuroradiology Courtesy of Dr. Jennifer McCarty, UT Houston ASNR Case of the Week | @theASNR

  3. Additional Info Differential diagnosis: Atlantoaxial Distraction Multiple choice question What is the diagnosis? Atlanto-Occipital Dissociation Occipital Condylar Fracture Atlantoaxial Distraction Rotatory Subluxation Reference link: https://pubs.rsna.org/doi/10.1148/rg.2015150035 Diagnosis confirmed with MRI #ASNRCOTW American Society of Neuroradiology Courtesy of Dr. Jennifer McCarty, UT Houston ASNR Case of the Week | @theASNR

  4. Slide Example Gradient: Standard Large Arrows (Light): Standard Small Arrows (Light): Standard Large Arrows (Dark): Standard Small Arrows (Dark): #ASNRCOTW American Society of Neuroradiology Courtesy of ASNR Case of the Week | @theASNR

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