Presentation
Fall from a horse. Neck pain and paresthesia.
Patient Data
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Undisplaced fractures of the C1 posterior arch without involvement of the transverse foramina.
Fracture through the base of the dens with approximately 2.8 mm posterior displacement of the dens about the body of C2. Minimally displaced fracture of the C2 spinous process.
Minor widening of the right lateral atlanto-dens interval is likely related to patient's head position turned to the left.
Normal facet joint alignment is maintained.
No bony narrowing of the central canal. Prevertebral soft tissue stranding at C1 and C2.
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High T2 signal at the C1 level of the spinal cord is consistent with traumatic edema. Spinal canal remains capacious. Diffuse edema within the ligamentum nuchae and prevertebral region.
Acute T2 and T3 compression fractures with minor collapse.
Odontoid fracture has features suggesting synchronicity.
Case Discussion
This case illustrates acute cervical spine trauma with a hyperflexion mechanism showing multiple fractures and acute spinal cord injury characterized by focal edema and swelling.
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