Patients with atlanto-occipital dislocation (AOD) are increasingly being transported to emergency rooms, alive, by the improved pre-hospital emergency rescue system. The author reports a fatal case of AOD with severe neurovascular injuries following a high-speed pedestrian collision. Therefore, nowadays, neurosurgeons can expect an increase in the occurrence of such cases; an early diagnosis and prompt occipitocervical fusion can save lives. This report reviews the current concepts of AOD in mild to fatal conditions.
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