Vascular insufficiency and differential distortion of brain and cord caused by cervicomedullary football injuries

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Abstract
✓ The problem of serious and fatal football injuries involving the cervicomedullary junction is presented. The mechanisms of such injuries (“stick blocking,” “spearing”) have been analyzed with the help of motion pictures of the action. The second cervical segment of the spinal cord was the commonest site of pathological change. A poor collateral vascular supply to the vertebrobasilar region, compression of the venous sinus, and the great disparity between the distortion of the freely mobile brain and the relatively fixed cervical spinal cord were implicated as the most likely background for the damage, which in turn may lead to acute cerebral edema and tentorial or tonsilar herniation.