Presentation
Victim of a hit-and-run. Total body CT ordered.
Patient Data
Traumatic findings:
craniocervical dissociation - 20 mm from the basion to the edge of the odontoid peg
brain edema - preserved gray-white matter differentiation but ventricles are narrowed, sulci are effaced, and basal cisterns are obliterated
subarachnoid hemorrhage in interpeduncular cistern and in fourth ventricle
intradural hematoma along the spinal canal, surrounding the spinal cord
extensive prevertebral hematoma
right buccal and suprasternal subcutaneous emphysema
hypertrophic adenoids
The chest showed relatively mild traumatic findings. The abdomen and pelvis were unharmed. Both tibiae and fibulae were shattered.
Case Discussion
A tragic case of a child who was hit by a car moving at high velocity with consequent atlanto-cervical dissociation incompatible with life, as the medulla oblongata is distracted and many neurons are severed in the process.