File:Atlanto-occipital dissociation - Traynelis type 1 (Radiopaedia 87570-103948 Coronal bone window 18).jpg

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Summary:

Description
  • Radiopaedia case ID: 87570
  • Image ID: 54570852
  • Image stack position: 18/61
  • Plane projection: Coronal
  • Aux modality: bone window
  • Modality: CT
  • System: Musculoskeletal
  • Findings: Anterior dislocation of the occipital condles relative to the lateral masses of C1 - type 1 atlanto-occipitial dislocation. Associated comminuted fractures of bilateral occipital condyles with medial displacement of the fracture fragments. The articulating process of C1 is subluxed posteriorly with marked widening of the joint space. Avulsion fracture from the anterior aspect of the left C1 articulating process. Marked widening between the basion and dens of C2. Basion dental interval 12.5 mm. Suspected injury/disruption of the anterior longitudinal ligament. The dens is intact. Widening C1-C2 articulation suggest ligamentous injury at this level. Marked prevertebral soft tissue swelling anterior to C1 and C2 cervical vertebral bodies.Anterior mild anterior subluxation of C3 on C4 and C4 on C5. The adjacent facet joints are intact. Mild widening of the C5/6 and C6/7 intervertebral disc spaces - this may represent an acute injury or be long standing (as there has been prior laminectomy at C6/7.) Soft tissue ossification on the left anterior aspect of the C5 vertebral body likely chronic. Suspected anterior epidural hematoma within the upper cervical spinal canal from C1 to C5. Subcutaneous air within the neck and prevertebral soft tissue presumably air dissecting superiorly from the pneumothorax. Low density subcutaneous fluid below the thyroid cartilage anterior to the trachea extending down into the superior mediastinum may represent an evolving subcutaneous hematoma. ETT and NGT in situ.
Date Published: 15th Mar 2021
Source https://radiopaedia.org/cases/atlanto-occipital-dissociation-traynelis-type-1
Author Craig Hacking
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

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