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Dens fracture with atlantoaxial subluxation and cord hemorrhage

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Car accident.

Patient Data

Age: 75
Gender: Male

Type 2 dens fracture with posterior displacement of the dens and C1 relative to the remainder of C2. Bilateral atlantoaxial joint subluxation (capsular disruption), disruption of the posterior atlantoaxial ligament and ALL tear with prevertebral hematoma. There is mild compression of the cord at this level but prominent heterogrneous signal within the cord including intrinsic T1 signal and susceptibility on the gradient sequence consistent with cord hemorrhage. In addition, there is thin posterior epidural hematoma descending from the injury level down to the upper thoracic spine.  

Case Discussion

Dens fracture with atlantoaxial subluxation, ligamentous injuries, cord hematoma and descending epidural hematoma. 

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