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Hypoplastic neural arch: An anomaly of the first cervical vertebra
Radiolog,v HYPOPLASTIC NEURAL ARCH: AN ANOMALY OF THE FIRST CERVICAL VERTEBRA
A 22-year-old
woman underwent orthodontic treatment and, as part of the treatment planning workup, had a lateral cephalometric radiograph taken. Examination of the lateral cephalograph revealed a distinct separation of the posterior arch of the first cervical vertebra, from the lateral masses connecting the posterior and anterior arches (Figs. 1 and 2).
A
OF TWO DENTAL UNITS FROM A MOTOR VEHICLE
3 1-year-old unrestrained female driver was involved in an accident in which her car was struck on the driver’s side and she was catapulted forward through the windshield. She sustained multiple orthopedic injuries requiring rigid fixation and closed neurologic injuries necessitating a ventriculostomy. In addition, multiple facial soft tissue injuries included a full thickness chin laceration and partial thickness transection of the anterior half of the tongue, with total avulsion of the right anterior lateral third of the tongue. Finally, a dentoalveolar fracture with complete avulsion of all four maxillary incisors was noted. After a prolonged extrication, the patient underwent a blind nasal intubation in the field for airway protection. In the operating room, two of the patient’s incisors were recovered within the tongue wound together with a sharp metallic foreign object. Visualization of one of the incisors may be overlooked on cursory examination of the posteroanterior chest x-ray film at
535
The medical history was noncontributory and there was no previous trauma to the neck. This is probably a case of developmental dehiscence of the lateral components of the posterior arch of the atlas. Donald M. Russell Department of Orthodontics Howard Universitll College of Dentistq 600 “w” Street NW Washington, DC 20059
Fig. 2.
Fig. 1.
ASPIRATION RESULTING ACCIDENT
forum
the level of the fifth thoracic vertebrae (Fig. 1). This is more clearly delineated on close-up examination (Fig. 2) at the level of the carina, where bifurcation of the trachea may be noted at the terminus of the endotracheal tube. Cervical spine films revealed the presenceof a seconddental unit lateral to the aryepiglottic fold within the piriform fossaadjacent to the endotracheal tube (Figs. 3 and 4).
Fig. 1. barely
Posteroanterior distinguishable
film at level
of chest of carini.
with
dental
unit
A 22-year-old
woman underwent orthodontic treatment and, as part of the treatment planning workup, had a lateral cephalometric radiograph taken. Examination of the lateral cephalograph revealed a distinct separation of the posterior arch of the first cervical vertebra, from the lateral masses connecting the posterior and anterior arches (Figs. 1 and 2).
A
OF TWO DENTAL UNITS FROM A MOTOR VEHICLE
3 1-year-old unrestrained female driver was involved in an accident in which her car was struck on the driver’s side and she was catapulted forward through the windshield. She sustained multiple orthopedic injuries requiring rigid fixation and closed neurologic injuries necessitating a ventriculostomy. In addition, multiple facial soft tissue injuries included a full thickness chin laceration and partial thickness transection of the anterior half of the tongue, with total avulsion of the right anterior lateral third of the tongue. Finally, a dentoalveolar fracture with complete avulsion of all four maxillary incisors was noted. After a prolonged extrication, the patient underwent a blind nasal intubation in the field for airway protection. In the operating room, two of the patient’s incisors were recovered within the tongue wound together with a sharp metallic foreign object. Visualization of one of the incisors may be overlooked on cursory examination of the posteroanterior chest x-ray film at
535
The medical history was noncontributory and there was no previous trauma to the neck. This is probably a case of developmental dehiscence of the lateral components of the posterior arch of the atlas. Donald M. Russell Department of Orthodontics Howard Universitll College of Dentistq 600 “w” Street NW Washington, DC 20059
Fig. 2.
Fig. 1.
ASPIRATION RESULTING ACCIDENT
forum
the level of the fifth thoracic vertebrae (Fig. 1). This is more clearly delineated on close-up examination (Fig. 2) at the level of the carina, where bifurcation of the trachea may be noted at the terminus of the endotracheal tube. Cervical spine films revealed the presenceof a seconddental unit lateral to the aryepiglottic fold within the piriform fossaadjacent to the endotracheal tube (Figs. 3 and 4).
Fig. 1. barely
Posteroanterior distinguishable
film at level
of chest of carini.
with
dental
unit