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Atlas fracture with Currarino type A congenital defect

Case contributed by Akos Jaray
Diagnosis certain

Presentation

Fall from top to bottom of stairs. Head injury, neck stiffness and mild tenderness.

Patient Data

Age: 65 years
Gender: Male

The left lateral mass of the atlas shows comminuted fracture with separation. The fracture line extends to the vertebral canal as well.

Currarino type A deformity of the atlas can also be noted in the midline in keeping with a congenital fusion defect with well-corticated contours.

Case Discussion

No circumscribed abnormality found on head CT (not uploaded), but in case of unexplained focal neurological symptoms (headache at the back of the head, posterior circulation stroke symptoms) one might raise the suspicion of vertebral artery dissection as the fracture line extends to the vertebral canal.

Being aware of congenital vertebral malformations (as C1 fusion defect in the midline here) can be useful in a trauma case like this not to highlight these as trauma-related findings.

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