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Brain
- large volume sub-arachnoid haemorrhage, most pronounced within the basal cisterns and Sylvian fissures
- preserved grey-white matter differentiation
Cervical spine
- craniocervcial dissociation with significant inferior and posterior translation of C1 relative to the skull base
- transverse right occipital condyle fracture. Further occipital bone fractures
- mild widening of the right atlanto-axial joint - dens interval suggesting atlanto-axial articulation disruption
- gross prevertebral oedema without cervical spine fracture
Carotid/circle of Willis angiogram
- transection of both vertebral arteries with non-opacification of the right vertebral artery at the level of C1 and the left vertebral artery at the skull base
- contrast blush / extravasation of the left vertebro-basilar junction in keeping with active haemorrhage (causing large volume SAH)
- minor luminal irregularity of both internal carotid arteries in keeping with low grade carotid blunt cerebrovascular injury
- normal opacification of the major circle of Willis branches with reconstitution of flow to the posterior circulation via the circle of Willis