MRI
There is redemonstration of ventrally dislocated occipital condyles on the C1 lateral masses. There is significant prevertebral oedema at the level of C3, extending superiorly to the level of the nasopharynx and inferiorly to the level of T1. There are multiple subdural haematomas within the anterior upper cervical spine from C1 to C3. The cervical spinal cord maintains normal calibre and signal intensity.
At C1-C2, sagittal STIR images demonstrate an abnormal signal and irregularity of the tectorial membrane. There is extensive oedema within the C1-C2 interspinous ligaments. The posterior atlantooccipital membrane is disrupted. There is likely disruption of the transverse ligament.
There is an increased T1 signal along the anterior longitudinal ligament. No significant spinal canal or foraminal compromise.