Skip to main content
Advertisement
  • Main menu
  • User menu
  • Search
  • English ▼
    • English
    • Afrikaans
    • Albanian
    • Amharic
    • Arabic
    • Armenian
    • Azerbaijani
    • Basque
    • Belarusian
    • Bengali
    • Bosnian
    • Bulgarian
    • Catalan
    • Cebuano
    • Chichewa
    • Chinese (Simplified)
    • Chinese (Traditional)
    • Corsican
    • Croatian
    • Czech
    • Danish
    • Dutch
    • Esperanto
    • Estonian
    • Filipino
    • Finnish
    • French
    • Frisian
    • Galician
    • Georgian
    • German
    • Greek
    • Gujarati
    • Haitian Creole
    • Hausa
    • Hawaiian
    • Hebrew
    • Hindi
    • Hmong
    • Hungarian
    • Icelandic
    • Igbo
    • Indonesian
    • Irish
    • Italian
    • Japanese
    • Javanese
    • Kannada
    • Kazakh
    • Khmer
    • Korean
    • Kurdish (Kurmanji)
    • Kyrgyz
    • Lao
    • Latin
    • Latvian
    • Lithuanian
    • Luxembourgish
    • Macedonian
    • Malagasy
    • Malay
    • Malayalam
    • Maltese
    • Maori
    • Marathi
    • Mongolian
    • Myanmar (Burmese)
    • Nepali
    • Norwegian
    • Pashto
    • Persian
    • Polish
    • Portuguese
    • Punjabi
    • Romanian
    • Russian
    • Samoan
    • Scottish Gaelic
    • Serbian
    • Sesotho
    • Shona
    • Sindhi
    • Sinhala
    • Slovak
    • Slovenian
    • Somali
    • Spanish
    • Sudanese
    • Swahili
    • Swedish
    • Tajik
    • Tamil
    • Telugu
    • Thai
    • Turkish
    • Ukrainian
    • Urdu
    • Uzbek
    • Vietnamese
    • Welsh
    • Xhosa
    • Yiddish
    • Yoruba
    • Zulu

Main menu

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • Advancing NeuroMRI with High-Relaxivity Contrast Agents
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home

User menu

  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

ASHNR American Society of Functional Neuroradiology ASHNR American Society of Pediatric Neuroradiology ASSR
  • Alerts
  • Log in

Advanced Search

English ▼
  • English
  • Afrikaans
  • Albanian
  • Amharic
  • Arabic
  • Armenian
  • Azerbaijani
  • Basque
  • Belarusian
  • Bengali
  • Bosnian
  • Bulgarian
  • Catalan
  • Cebuano
  • Chichewa
  • Chinese (Simplified)
  • Chinese (Traditional)
  • Corsican
  • Croatian
  • Czech
  • Danish
  • Dutch
  • Esperanto
  • Estonian
  • Filipino
  • Finnish
  • French
  • Frisian
  • Galician
  • Georgian
  • German
  • Greek
  • Gujarati
  • Haitian Creole
  • Hausa
  • Hawaiian
  • Hebrew
  • Hindi
  • Hmong
  • Hungarian
  • Icelandic
  • Igbo
  • Indonesian
  • Irish
  • Italian
  • Japanese
  • Javanese
  • Kannada
  • Kazakh
  • Khmer
  • Korean
  • Kurdish (Kurmanji)
  • Kyrgyz
  • Lao
  • Latin
  • Latvian
  • Lithuanian
  • Luxembourgish
  • Macedonian
  • Malagasy
  • Malay
  • Malayalam
  • Maltese
  • Maori
  • Marathi
  • Mongolian
  • Myanmar (Burmese)
  • Nepali
  • Norwegian
  • Pashto
  • Persian
  • Polish
  • Portuguese
  • Punjabi
  • Romanian
  • Russian
  • Samoan
  • Scottish Gaelic
  • Serbian
  • Sesotho
  • Shona
  • Sindhi
  • Sinhala
  • Slovak
  • Slovenian
  • Somali
  • Spanish
  • Sudanese
  • Swahili
  • Swedish
  • Tajik
  • Tamil
  • Telugu
  • Thai
  • Turkish
  • Ukrainian
  • Urdu
  • Uzbek
  • Vietnamese
  • Welsh
  • Xhosa
  • Yiddish
  • Yoruba
  • Zulu
  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • Advancing NeuroMRI with High-Relaxivity Contrast Agents
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds

AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates


Improved Turnaround Times | Median time to first decision: 12 days

Research ArticlePediatric NeuroimagingF

Tectorial Membrane Injury: Frequently Overlooked in Pediatric Traumatic Head Injury

A. Meoded, S. Singhi, A. Poretti, A. Eran, A. Tekes and T.A.G.M. Huisman
American Journal of Neuroradiology November 2011, 32 (10) 1806-1811; DOI: https://doi.org/10.3174/ajnr.A2606
A. Meoded
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
S. Singhi
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
A. Poretti
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
A. Eran
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
A. Tekes
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
T.A.G.M. Huisman
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Responses
  • References
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Fig 1.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 1.

    Sagittal T2- (A) and T1-weighted (B) MR images of a 9-year-old girl (patient 4) who presented with craniocervical junction−related symptoms after an MVA show a REH (white arrow) with associated tectorial membrane disruption (short white arrow) and posterior dislocation of the dens. C, Sagittal T2-weighted MR image of an age-matched healthy control patient for comparison.

  • Fig 2.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 2.

    A, Axial T2- weighted MR image of a 6-year-old girl (patient 5) who presented with craniocervical junction−related symptoms (GCS = 13) after a MVA shows a retroclival hyperintense fluid collection with stretching of the tectorial membrane (white arrow). B, Sagittal T2-weighted image of a 6-year-old girl (patient 8) who presented with cervical pain (GCS = 15) after an MVA demonstrates REH (white arrow) and an associated tectorial membrane disruption (short white arrow). C and D, Sagittal T2-weighted MR images of a 4-year-old boy (patient 1) who presented with a sixth cranial nerve palsy (GCS = 6) after a MVA shows an apical ligament injury (white arrow) with associated tectorial membrane disruption (D, short white arrow).

  • Fig 3.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 3.

    Sagittal reconstruction of a CT scan of a 6-year-old boy (patient 3) after a fall (GCS = 15) demonstrates an REH (thick white arrow), which causes mild compression of the spinal cord. CT scan also shows the anterior atlanto-occipital ligament (thin white arrow) and a suspected apical ligament disruption (black arrow).

Tables

  • Figures
  • Mechanism of trauma, diagnostic modality, clinical signs and symptoms on admission, associated injuries, treatment, and outcome in 10 children with traumatic REH

    No.Sex/AgeMechanism of InjuryDiagnostic ModalityClinical Signs/Symptoms on AdmissionAssociated InjuriesTreatmentOutcome
    1M/4 yrMVACT/MRGCS score, 6; left sixth cranial nerve palsyMultiple skull fractures; intraparenchymal and subdural hematoma; shear injuries; left internal carotid artery dissection; transverse ligament injuryConservative (Miami J collar)Neurologic impairment related to DAI
    2F/15 yrCattle ropingCT/MRGCS score, 7Intracranial hematoma; cerebral contusions; extra-axial hemorrhage; shear injuriesConservative (Miami J collar)Neurologic impairment related to DAI
    3M/6 yrFallCTGCS score, 15; unremarkableStretched tectorial membrane; apical ligament injury; mild compression of the brain stemConservativeFull recovery
    4F/9 yrMVACT/MRGCS score, 6; left fourth, sixth, tenth, twelfth cranial nerve palsy; paresis of the left arm; bilateral upgoing toesTectorial membrane disruption; left occipital condylar fracture with subluxation of C-spine; moderate compression of the brain stem; intraparenchymal hematoma; cerebral contusion, extra-axial hemorrhageSurgical fixation C0-C2Neurologic impairment related to DAI
    5F/6 yrMVACT/MRGCS score, 13; nausea, headache; bilateral sixth, ninth, twelfth cranial nerve palsyTectorial membrane disruptionConservative (Miami J collar)Full recovery
    6F/21 moFallCT/MRGCS score, 14; nausea, headacheTectorial membrane disruption; skull fracture; extra-axial hemorrhage; apical ligament injuryConservative (Miami J collar)Full recovery
    7M/13 yrGo-cart accidentCTGCS score, 15; mild nauseaStretched tectorial membrane; left occipital condylar fractureConservative (Miami J collar)Full recovery
    8F/6 yrMVACT/MRGCS score, 15; cervical painTectorial membrane disruption; mild compression of the brain stemConservative (Miami J collar and thoracic lumbar sacral orthosis brace)Full recovery
    9F/9 yrMVACT/MRGCS score, 5Stretched tectorial membraneConservative (Miami J collar)Full recovery
    10M/2 yrCar versus pedestrianCT/MRGCS score, 13; left femur fractureApical and posterior atlanto-occipital membrane injury; skull fractureConservative (Miami J collar)Full recovery
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 32 (10)
American Journal of Neuroradiology
Vol. 32, Issue 10
1 Nov 2011
  • Table of Contents
  • Index by author
Advertisement
Print
Download PDF
Email Article
Cite this article
0 Responses
Respond to this article
Share
Bookmark this article
Tectorial Membrane Injury: Frequently Overlooked in Pediatric Traumatic Head Injury
A. Meoded, S. Singhi, A. Poretti, A. Eran, A. Tekes, T.A.G.M. Huisman
American Journal of Neuroradiology Nov 2011, 32 (10) 1806-1811; DOI: 10.3174/ajnr.A2606
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
Purchase

Jump to section

  • Article
    • Abstract
    • Abbreviations
    • Materials and Methods
    • Results
    • Discussion
    • Conclusions
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • Responses
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Application of Normative Occipital Condyle-C1 Interval Measurements to Detect Atlanto-Occipital Injury in Children
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • Pediatric Glioma:Imaging Clusters,Molecular Traits
  • Clinical SVR of Fetal Brain MRI
  • Comparing MRI Perfusion in Pediatric Brain Tumors
Show more PEDIATRIC NEUROIMAGING

Similar Articles

  • Systematic Review and Meta-Analysis of Radiation Dose Reduction Studies in Pediatric Head CT
  • Autoimmune Encephalitis: Imaging and Review
  • Susceptibility Mapping in Post-Concussion Symptoms
  • Comparing MRI Perfusion in Pediatric Brain Tumors
  • Sodium MRI in Pediatric Brain Tumors
See more
Advertisement

Indexed Content

  • Current Issue
  • Accepted Manuscripts
  • Article Preview
  • Past Issues
  • Editorials
  • Editor's Choice
  • Fellows' Journal Club
  • Letters to the Editor
  • Video Articles

Cases

  • Case Collection
  • Archive - Case of the Week
  • Archive - Case of the Month
  • Archive - Classic Case

More from AJNR

  • Trainee Corner
  • Imaging Protocols
  • MRI Safety Corner
  • Book Reviews

Multimedia

  • AJNR Podcasts
  • AJNR Scantastics

Resources

  • Turnaround Time
  • Submit a Manuscript
  • Submit a Video Article
  • Submit an eLetter to the Editor/Response
  • Manuscript Submission Guidelines
  • Statistical Tips
  • Fast Publishing of Accepted Manuscripts
  • Graphical Abstract Preparation
  • Imaging Protocol Submission
  • Evidence-Based Medicine Level Guide
  • Publishing Checklists
  • Author Policies
  • Become a Reviewer/Academy of Reviewers
  • News and Updates

About Us

  • About AJNR
  • Editorial Board
  • Editorial Board Alumni
  • Alerts
  • Permissions
  • Not an AJNR Subscriber? Join Now
  • Advertise with Us
  • Librarian Resources
  • Feedback
  • Terms and Conditions
  • AJNR Editorial Board Alumni

American Society of Neuroradiology

  • Not an ASNR Member? Join Now

© 2025 by the American Society of Neuroradiology All rights, including for text and data mining, AI training, and similar technologies, are reserved.
Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire
Email this Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Tectorial Membrane Injury: Frequently Overlooked in Pediatric Traumatic Head Injury
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Cite this article
A. Meoded, S. Singhi, A. Poretti, A. Eran, A. Tekes, T.A.G.M. Huisman
Tectorial Membrane Injury: Frequently Overlooked in Pediatric Traumatic Head Injury
American Journal of Neuroradiology Nov 2011, 32 (10) 1806-1811; DOI: 10.3174/ajnr.A2606

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

We use cookies on this site to enhance your user experience. By clicking any link on this page you are giving your consent for us to set cookies.