If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
A 28-year-old woman presented to the Emergency Department complaining of severe neck
pain after a motor vehicle collision. Emergency medical services reported damage to
both the front and rear of the vehicle. The patient denied significant past medical
history, alcohol use, or pertinent review of symptoms. She complained of 10/10 sharp
neck pain made worse with any movement. Physical examination revealed only tenderness
to palpation of the upper cervical spine (C-spine) in the midline without neurologic
deficits. A computed tomography (CT) scan of the C-spine was performed (Figure 1, Figure 2) and showed a small bony fragment at the craniocervical junction on the right, consistent
with possible transverse ligament avulsion. The patient was admitted to the neurosurgical
intensive care unit and magnetic resonance imaging (MRI) of the C-spine was obtained
(Figure 3). The MRI study showed hyperintensity superior to the odontoid that was read as possibly
reflecting edema or hemorrhage and was supportive of the suspicion of an avulsion
injury, perhaps involving the transverse ligament. The transverse ligament otherwise
appeared to be intact.
Figure 1Computed tomography scan of the cervical spine in coronal plane showing avulsion fracture
of C1 (arrow).
