Craniocervical dissociation

Case contributed by Yaïr Glick
Diagnosis certain

Presentation

Motor vehicle crash

Patient Data

Age: 5 years
Gender: Female
ct

Craniocervical dissociation, basion-dens interval is 18 mm.

Case Discussion

5-year-old girl, arrived to the ED by ambulance (mobile ICU) from the scene of a motor vehicle collision. She was already sedated and intubated on the scene. On arrival, she was haemodynamically unstable; BP 70/30 mmHg, pulse 140/min. Good bilateral air entry. Cannulas inserted, blood drawn for typing and crossmatching, infusion of O- blood instituted.
FAST showed free intraperitoneal fluid.
Craniocervical dissociation clearly demonstrated on total body CT, among many trauma-related findings.
The patient was transferred to a larger trauma center with a neuroradiologic facility.

NB: the patient's age can be assessed by the number of unerupted upper and lower teeth.

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