30 year old female unrestrained passenger in high speed motor vehicle accident with loss of consciousness and PEA arrest at the scene.
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Distraction type injury at the craniocervical junction. Fracture-dislocation through the atlas and involving the atlanto-occipital articulations.
Basion-dens interval is 28.7mm. The usual interval is <8.5mm on CT.
Global reduced attenuation with loss of CSF spaces. There is widespread subarachnoid blood, particularly in the posterior fossa suggestive of traumatic subarachnoid haemorrhage.