Cranio-cervical instability

Signs & symptoms

• Feeling like they “need to hold onto their head”
• Neck pain.
• Occipital headache.
• Dizziness.
• Altered neurology made worse by movement of head on neck.

Risk factors

• Down Syndrome, RA, tumours.
• Major trauma RTA (fall onto head or direct blow)
• Minor trauma direct to head in osteoporotic patient.
• Structural deformities such as Atlantoaxial instability or Chiari malformation.

Acute/traumatic/progressive – discuss with on call/refer to ED.

Chronic/stable refer urgently to Orthopaedics.