Presentation
Motor vehicle accident. Complaining of severe neck pain and hoarseness of the voice.
Patient Data
There is a dislocation of the occipital condyles (left and right) ventrally on the C1 lateral masses. There is significant prevertebral edema from the skull base through C4. Additional soft tissue stranding and edema are seen in the right lateral neck and along the left scalene musculature, which is also concerning for sequelae of trauma and soft tissue injury.
There is redemonstration of ventrally dislocated occipital condyles on the C1 lateral masses. There is significant prevertebral edema at the level of C3, extending superiorly to the level of the nasopharynx and inferiorly to the level of T1. There are multiple subdural hematomas within the anterior upper cervical spine from C1 to C3. The cervical spinal cord maintains normal caliber and signal intensity.
Lateral intraoperative radiograph revealing fixation of the occipital bone to C2 and C3 via an occipital plate and bilateral pedicle screws at C2 and C3.
Case Discussion
This is a case of an atlanto-occipital dislocation following a high-speed motor vehicle accident. Surprisingly, the patient was neurologically intact and primarily complained of neck pain. Following the procedure, there were no acute complications.
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