Atlantooccipital dislocation in pediatric age: History of a survivor patient

Introduction: Atlantooccipital dislocation (AOD) is a rare but fatal injury, representing only 1% of cervical trauma cases, more common in children due to anatomical and physiological factors. Prompt diagnosis and timely treatment are crucial for favorable outcomes.Case Description: We present the case of a six-year-old male involved in a motor vehicle accident, presenting with quadriplegia and fluctuating levels of consciousness. Initial CT scans revealed subarachnoid hemorrhage and abnormal radiological indices. MRI confirmed damage to critical ligaments and medullary contusion. The patient was immobilized using a halo vest and later underwent successful occipitocervical fusion (OCF).Discussion: AOD diagnosis is challenging due to its rarity and variable clinical presentation. Standard radiological indices may not always be indicative. MRI is essential for evaluating ligamentous and medullary involvement. While OCF remains the standard treatment, halo vest immobilization can be a viable option in select cases, particularly in pediatric patients.Conclusion: High suspicion is necessary for diagnosing AOD in pediatric trauma cases. OCF is the standard treatment, but halo vest immobilization may be considered in certain scenarios.