A new approach to upper cervical injuries.

Severe injuries to the upper cervical region can be the cause of death. Standard autopsy techniques are inadequate for examination of this area. Therefore a technique has been developed that gives excellent visualization and allows removal of the brain and spinal cord in one piece. With the body prone a midline incision is made from the top of the head to the sacrum. The skull is sawed in a circle from one side of the foramen magnum around the top of the skull to the other side of the foramen magnum. The lamina of the neural arches of the vertebral column are sawed. With the removal of the piece of skull and the posterior portions of the neural arches, the posterior half of the cerebral cortex, cerebellum, and entire spinal cord are exposed. The entire brain and spinal cord can be removed as a unit. Cases are selected by history, X-ray examination, or floppy head. Four cases in which this approach has been helpful are briefly mentioned.