Affiliations: Department of Neurosurgery, Sanjay Gandhi Postgraduate
Institute of Medical Sciences, Lucknow, India | Department of Critical Care Medicine and Intensive
Care Unit, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow,
India
Note: [] Correspondence: Raj Kumar, M.D., Professor & Head,
Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical
Sciences, Lucknow – 226014, U.P., India. E-mail: rajkumar1959@gmail.com;
rajkumar@sgpgi.ac.in
Abstract: Grisel's syndrome is a rare condition characterized by atlantoaxial
subluxation following an inflammatory process in the head and neck region. It
occurs more commonly in children and usually presents with cervical pain and
torticollis, in addition to symptoms of the primary infection. A case of
Grisel's syndrome is discussed here who suddenly developed quadriplegia with
severe respiratory compromise and ultimately diagnosed as reducible
atlantoaxial subluxation with hematomyelia. Hematomyelia was extending from
medulla to the third cervical vertebrae level of cord. The case was managed
successfully by posterior fusion. Though the clinical improvement occurred
following posterior fusion, but there was no optimum radiological reduction of
the reducible atlantoaxial subluxation. This case emphasizes the importance of
posterior fusion in Grisel's syndrome where an offending posterior indentation
of upper cervical cord by dislocated posterior arch, if dealt with; the
clinical improvement can be achieved even without sufficient anterior reduction
of subluxation. The reasons of hematomyelia and nonreduction atlantoaxial
subluxation are discussed here.
