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Case 23 - Occipital Condyle Fracture

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This was an individual who was in a motor vehicle collision

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and complained of sort of a vague occipital headache.

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And we performed the CT scan, and in the subaxial CT scan,

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we really didn't find very much.

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But you notice that on this patient's occipital condyle,

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you see this irregularity that is seen on the axial scan going

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through and through without sharp borders and

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without sclerosis, so likely an acute injury.

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And on the coronal reconstruction,

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you see that this represents a single piece, a solitary piece,

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sort of a Type II occipital condyle avulsion fracture.

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These, in and of itself,

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are often do not require surgical intervention or fixation.

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We would recommend getting an MRI

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scan to make sure that there is

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ligamentous integrity.

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The other thing to do is to also look at this case on the soft

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tissue windows, because we want to make sure that there's not

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an epidural hematoma that is compromising the spinal canal.

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So when you pull up the soft tissue window

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at the level of this fracture,

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you notice that the cervicomedullary junction in

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the upper cervical spinal cord is perfectly fine.

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And there really is no evidence of a significant epidural

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hemorrhage associated with the avulsion of this bone fragment.

Report

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Neuroradiology

Head and Neck

Emergency

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