Presentation
Fall from top to bottom of stairs. Head injury, neck stiffness and mild tenderness.
Patient Data
The left lateral mass of the atlas shows comminuted fracture with separation. The fracture line extends to the vertebral canal as well.
Currarino type A deformity of the atlas can also be noted in the midline in keeping with a congenital fusion defect with well-corticated contours.
Case Discussion
No circumscribed abnormality found on head CT (not uploaded), but in case of unexplained focal neurological symptoms (headache at the back of the head, posterior circulation stroke symptoms) one might raise the suspicion of vertebral artery dissection as the fracture line extends to the vertebral canal.
Being aware of congenital vertebral malformations (as C1 fusion defect in the midline here) can be useful in a trauma case like this not to highlight these as trauma-related findings.