How to Survive an 'Internal Decapitation'

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In January of last year, 22-year-old Brock Meister of Plymouth, Indiana suffered an "internal decapitation" during a serious car crash. When his car flipped over after hitting a patch of ice, the ligaments connecting his skull to his atlas – the first vertebra of the spine – were severed, leaving his skull perilously close to detaching entirely.

Internal decapitation, more formerly known as atlanto-occipital dislocation, was first described in the medical literature back in 1908. It results from traumatic hyperextension of the neck backwards. Simultaneous sideways twisting can make a tear more likely and exacerbate damage. Occuring in roughly one percent of all spinal injuries, it is often fatal. Seventy percent of victims will die instantly, as the lack of supporting ligaments combined with an outside force leaves the skull completely disconnected from the spine, damaging the brain stem's medulla oblongata in the process. Any injury to this vital part of the brain can result in cardiopulmonary arrest, as it controls the heart and lungs.

Fortunately, this fate did not befall Meister, as the car crash left his skull detached but his vital brain regions relatively unharmed. Friends wisely prevented him from moving after the accident to prevent any further harm, and when paramedics arrived, they quickly fitted Meister with a neck brace.

Stabilizing the neck after an accident can be a lifesaver in cases of internal decapitation. Often, paralysis and loss of consciousness will clue medical professionals in to the presence of the rare spinal injury, but occasionally, only neck stiffness and pain will be present. If the patient's neck is free to move around, any swift or sudden movement could detach the skull from the spine. A CT scan or MRI is required to diagnose internal decapitation.

Once spotted, the primary treatment method is to fuse the skull and spine back together with metal plates, rods, and screws, as well as a bone graft, often from the pelvis or rib. After extensive rehabilitation, movement below the neck can completely return along with some movement at the neck.

A year after his internal decapitation, Meister finds himself in this situation – hobbled and in pain, but very lucky to be alive.

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