A lateral mass fracture of C1 associated with left vertebral artery and mid-basilar artery occlusion.
Extreme acceleration and deceleration forces as well as axial loading are exerted at the occipito-cervical junction of drivers involved in high-velocity motor vehicle accidents, especially with fastened seatbelts. Injury at this level, usually lethal, can go unrecognized despite modern emergency management of the unconscious patient. A precise neurologic and radiographic workup of damage to this area is often not possible or overlooked in the initial phase of such severe trauma. We describe a patient with multiple injuries who sustained a left vertebral artery occlusion associated with a left-sided lateral mass fracture of C1 and a basilar artery occlusion resulting in a locked-in syndrome after an automobile accident.
Schoeggl
A
A
Department of Neurosurgery, University of Vienna, Austria. andreas.schoeggl@univie.ac.at
Reddy
M
M
Bavinzski
G
G
D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D016103:Spinal Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology