Motor vehicle crash
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Craniocervical dissociation, basion-dens interval is 18 mm.
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.