Upcoming Events

0:01

This was an individual who was in a motor vehicle collision

0:04

and complained of sort of a vague occipital headache.

0:09

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

0:17

we really didn't find very much.

0:18

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

0:24

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

0:28

through and through without sharp borders and

0:31

without sclerosis, so likely an acute injury.

0:35

And on the coronal reconstruction,

0:38

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

0:44

sort of a Type II occipital condyle avulsion fracture.

0:48

These, in and of itself,

0:50

are often do not require surgical intervention or fixation.

0:55

We would recommend getting an MRI

0:57

scan to make sure that there is

1:00

ligamentous integrity.

1:01

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

1:06

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

1:08

an epidural hematoma that is compromising the spinal canal.

1:13

So when you pull up the soft tissue window

1:17

at the level of this fracture,

1:18

you notice that the cervicomedullary junction in

1:21

the upper cervical spinal cord is perfectly fine.

1:24

And there really is no evidence of a significant epidural

1:28

hemorrhage associated with the avulsion of this bone fragment.

Case 23 - Occipital Condyle Fracture

HIDE

Interactive Transcript

Pro Tip: Click on a word in the transcript to jump to that point in the video

0:01

This was an individual who was in a motor vehicle collision

0:04

and complained of sort of a vague occipital headache.

0:09

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

0:17

we really didn't find very much.

0:18

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

0:24

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

0:28

through and through without sharp borders and

0:31

without sclerosis, so likely an acute injury.

0:35

And on the coronal reconstruction,

0:38

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

0:44

sort of a Type II occipital condyle avulsion fracture.

0:48

These, in and of itself,

0:50

are often do not require surgical intervention or fixation.

0:55

We would recommend getting an MRI

0:57

scan to make sure that there is

1:00

ligamentous integrity.

1:01

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

1:06

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

1:08

an epidural hematoma that is compromising the spinal canal.

1:13

So when you pull up the soft tissue window

1:17

at the level of this fracture,

1:18

you notice that the cervicomedullary junction in

1:21

the upper cervical spinal cord is perfectly fine.

1:24

And there really is no evidence of a significant epidural

1:28

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

© 2024 Medality. All Rights Reserved.

Contact Us Terms of Use Privacy Policy