Spontaneous atlantoaxial rotatory fixation in old age after cerebral infarction - Case report

Study Design. Case report of spontaneous Fielding,and Hawkins Type I atlant oaxial rotatory fixation in a 78-year-old man after hemiplegia and homonymo us hemianopsia caused by cerebral infarction. Objectives. To describe a case of spontaneous atlantoaxial rotatory fixatio n in old age and review previous rotatory fixation without adult cases of a tlantoaxial rotatory fixation without fracture. Summary of Background Data. Atlantoaxial rotatory fixation in adults is a r elatively rare finding and is mainly caused by trauma. To the author's know ledge, there has been no previous report of spontaneous atlantoaxial rotato ry fixation in old age. Methods. The patient's head was fixed in a 40 degrees left-rotated position . Left hemiplegia and homonymous leftside hemianopsia developed due to cere bral infarction. Computed tomography of the cervical spine clearly showed r otatory fixation of the atlas on the axis. Results. Successful reduction was obtained after 1 day of skull traction. Conclusions. It was hypothesized that repeated left-rotational stress due t o homonymous hemianopsia loaded to the atlantoaxial joint caused abnormal l axity of the joint.