Presentation
Unrestrained passenger in high speed motor vehicle accident with loss of consciousness and PEA arrest at the scene.
Patient Data
Age: 30 years
Gender: Female
From the case:
Atlanto-occipital dislocation
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Sagittal non-contrast

Distraction type injury at the craniocervical junction. Fracture-dislocation through the atlas and involving the atlanto-occipital articulations.
Basion-dens interval is 29 mm. The usual interval is <8.5 mm on CT.
Global reduced attenuation with loss of CSF spaces. There is widespread subarachnoid blood, particularly in the posterior fossa suggestive of traumatic subarachnoid hemorrhage.
From the case:
Atlanto-occipital dislocation
Sagittal cervical spine CT

Basion-dens distance 29 mm (should be <8.5 mm).