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Internal decapitation, atlanto-occipital dislocation or orthopedic decapitation, describes the rare medical condition in which the skull separates from the spinal column during severe head injury. This injury is usually fatal, since it usually involves nerve damage or severance of the spinal cord.

The practice of hanging relies on internal decapitation, as it creates a situation where subjects' necks are broken under their own weight. (A botched hanging can result in a gruesome external decapitation.)

There have been several survivors of the injury. In January 2007, a Lincoln, Nebraska woman survived the injury, as there was little nervous system damage.[1] In July 2007 an 11-year-old boy in Saskatoon, Saskatchewan also survived with a hospital stay of only two and a half weeks.[2] In April 2004, a 14-year-old Phoenix, Arizona boy suffered an internal decapitation after being struck by a car while on his bike. The boy recovered from his injuries, and was featured on the shows I Came Away Alive for the National Geographic Channel,[3] as well as Untold Stories of the E.R. and "Medical Incredible" for the Discovery Health Channel. In October 2008, a 9-year-old Hillsboro, Texas boy was internally decapitated during a car accident. Despite being given little chance for survival, he made an almost full recovery within 3 months of the incident and was able to return to school in the beginning of 2009.[4][5] Jon Wilhite, a former baseball player and Cal State Fullerton catcher, suffered the same injury in a vehicular collision on April 9, 2009. Jon Wilhite survived the injury.[6] In August 2009, 18-year-old Amanda Kapp survived this as well.[7]

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