Craniocervical junction injury

Case contributed by Dr Jane McEniery

Presentation

Motor vehicle accident. GCS 3.

Patient Data

Age: 3 years
Gender: Female

Cervical spine

Injury to the craniocervical junction with: 

  • widened basion-dens interval
  • widened lateral atlanto-axial articulations
  • widened interspinous distance between C1/C2
  • no visible fracture
  • prevertebral soft tissue swelling


​Chest

  • ETT tip in the trachea
  • left pneumothorax
  • atelectasis in the right upper and left lower lobes
  • tear of the posterior atlanto-axial membrane
  • edema within the atlanto-occipital articulations bilaterally
  • widening of the lateral atlanto-axial articulations
  • cervical cord contusion at C2 vertebral level
  • partial tear of the interspinous ligaments from C2-C7
  • intact ALL, PLL, tectorial membrane
  • epidural collection from C2-T1

Case Discussion

Case contributed by Dr Samuel Manikkam.

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