Cervical fracture and dissociation injury with vertebral artery transection

Case contributed by Anson Chan
Diagnosis certain

Presentation

High-speed motorbike crash. GCS 3.

Patient Data

Age: 30 years
Gender: Male

Dissociation of the cervical spine at the level of C2/C3.

There is complete dissociation with 30 mm distraction at the junction of the C2/C3 cervical bodies. A teardrop fracture of the C2 vertebral body is demonstrated. There is a large prevertebral hematoma and extensive soft tissue swelling. Angiography demonstrates abrupt termination of the bilateral mid vertebral arteries, likely due to post-traumatic transection.

Case Discussion

The high energy mechanism resulted in a high-grade distraction injury of the cervical spine at the level of C2/C3 with associated bilateral vertebral artery transection. This was an un-survivable injury.

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