Life-threatening internal decapitation can go without being diagnosed

What if every step you take, every move you make, every breath you breathe, you were at risk of becoming paralyzed, becoming a quadriplegic, or even dying?

That is what some people face, all because of an injury you cannot see, and many doctors misdiagnose or do not know how to treat it.

Micah Andrews just recently ran for the first time in almost a year.

Micah’s dad, John Andrews, says, "We went downstairs and found him running, giggling, elated he could run, like he'd been free.”

Nine months before that, a day of shopping ended with a crash.

Micah’s mom, Heather Andrews, says, "He was looking like he was asleep. I put my hands on either side of his face, and breath was coming."

John says, "The ambulance went right by me. I had no idea it was hauling my family."

Micah’s mom and dad were dealing with the news that their little boy suffered severe brain damage, but while Micah was in his coma, doctors found another injury.

Dr. Nicholas Theodore, a neurosurgeon at Barrow Neurological Institute and St. Joseph’s Hospital and Medical Center in Phoenix, AZ, says, "All the ligaments connecting his skull to his spine were severed."

It is called internal decapitation. Micah’s head was still connected by the skin and the spinal cord, but no muscles were there to support it.

"All the rubber bands that connect the bones together and actually hold, fasten the skull to the spine, all torn. Any movement could be fatal for him

Dr. Theodore worked to relieve the pressure on Micah’s brain. Once that was done, he focused on what could leave the little boy a quadriplegic or even dead, but doctors cannot reattach the ligaments. They cannot be repaired.

"With each breath, you can see the skull and spine moving like two separate parts."

Dr. Theodore used a titanium rod to reattach the head. He then took a piece of Micah’s rib for extra support.

"That will grow together so that not only do we have the metal there, but there will be a boney bridge between his skull and his upper spine."

Micah will never be able to play contact sports, but Dr. Theodore says a child Micah’s age will get most of his motion back.

Doctors believe there may be many more like Micah who never make it to the ER or are told their problem cannot be fixed and die before they can be treated properly.

RESEARCH SUMMARY

BACKGROUND: Internal decapitation occurs when the ligaments connecting the skull to the spine are severed due to severe head trauma. Typically, the head is only held in place by the skin and spinal cord. Any movement could cause injury to the spinal cord and result in devastating neurological consequences or even death. Internal decapitation is five-times more common in children than it is in adults.
(SOURCE: http://www.bnaneuro.net/Pages/Docs/DrTheodore.html)

SURGERY: In order to fix internal decapitation, a neurologist may implant a titanium loop in the neck/head to reattach the base of the skull to the spine. A piece of the patient's rib may be removed and used to hold the rod in place.
(SOURCE: http://www.bnaneuro.net/Pages/Docs/DrTheodore.html)

SURGERY AFTERMATH: Although most patients who endure severe head trauma and internal decapitation have severe neurological damage, some will have a full recovery with no brain damage or neurological issues. In some cases, the patient will have full neurological function but will lack the ability to move the head in any direction. The surgery itself is very high risk and could result in paralysis, neurological damage or even death. After the surgery, patients have to be careful with their movement. One hard hit or fall could end in paralysis or death.
(SOURCE: http://www.bnaneuro.net/Pages/Docs/DrTheodore.html)

FOR MORE INFORMATION, PLEASE CONTACT:
Craig Boerner, National News Director
Vanderbilt University Medical Center
Nashville, TN
(615) 322-4747
Craig.boerner@vanderbilt.edu


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