Why is an Alanto-occiptial dislocation aka internal decapitation almost always fatal even if you make it to hospital?
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The primary reason is that it’s very hard to recognize initially, and many people don’t realize that you shouldn’t move someone with a neck/spine injury if it can be helped. Even slightly moving someone with this specific injury can hurt the spinal cord more, and possibly sever or damage it to the point that the victim is unable to breathe.
The slightest movement can irreparably damage your spinal cord. It’s hard to get someone from the injury site to the hospital without damaging it. Even if you’re extremely careful, it often can’t be avoided.
Spinal cord injuries cause damage to any spinal nerves that exit below the site. C3,4 and 5 spinal nerves connect to the diaphragm (breathing). The Atlas (where atlantoocciptal name comes from back bone is C1, which is the highest level of the spinal cord, so decapitation pretty much shuts off any spinal nerve functions below the site, including the ability to breathe. Even with proper medical care like putting the person on a a ventilator, by the time they make it to hospital, after all the movement, there spinal cord is now just a tube of toothpaste and they probably have suffered a HBI and/or died, and thus medical intervention has a poor outcome
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