Teenager after motor vehicle accident

CT of Type 2 fracture of the odontoid process of the C2 vertebral body and atlanto-occipital dissociation
Midline sagittal CT without contrast of the cervical spine (middle) shows a transverse comminuted fragmented fracture through the C2 vertebral body. There is anterior displacement of the C1 vertebral body resulting in compromise of the spinal canal. There is massive thickening of the retropharyngeal soft tissues due to a retropharyngeal hematoma. The basion-dens interval is abnormally increased. The off midline sagittal CTs (left and right) show distraction between the occipital condyles bilaterally and the C1 articular facets.

The diagnosis was a Type 2 fracture of the odontoid process of the C2 vertebral body and atlanto-occipital dissociation.