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  • Case Report
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Successful recovery from cardiac arrest due to atlantoaxial subluxation in Down syndrome: a case report



Down syndrome is the most common chromosomal abnormality associated with intellectual impairments. Unexpected deaths are common with this disease. There are certain difficulties in clarifying the cause of death because the manifestations may be quite diverse and involve many organ systems. Atlantoaxial subluxation is a dangerous complication of Down syndrome, as it may lead to cervical cord-medullary compression.

Case presentation

Herein, we present a case of Down syndrome in a patient who completely recovered from cardiac arrest due to atlantoaxial subluxation. The neck was immobilized during post-cardiac arrest care, and the patient underwent surgery after 14 days. The patient could walk independently and was discharged 3 months later. At the last follow-up 5 years after surgery, the patient’s general condition was good.


Physicians should be aware that atlantoaxial instability can cause cardiac arrest in patients with genetic syndromes.

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Fig. 1: Electrocardiogram recorded by an automated external defibrillator.
Fig. 2: CT scan of the neck demonstrating atlantoaxial subluxation.
Fig. 3: MRI of the neck.
Fig. 4: Extension and flexion lateral cervical spine radiographs demonstrating atlantoaxial instability.
Fig. 5

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Data availability

All data supporting the findings of this study are available within the article.


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Authors and Affiliations



HI was responsible for data collection, data analysis, and writing of the manuscript. YH, HK, MI, and YK contributed to the study conception and provided feedback on the manuscript. HO supervised the project.

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Correspondence to Hiroshi Imamura.

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Imamura, H., Hamano, Y., Kamijo, H. et al. Successful recovery from cardiac arrest due to atlantoaxial subluxation in Down syndrome: a case report. Spinal Cord Ser Cases 10, 37 (2024).

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