Jacobs Journal of Emergency Medicine

Atlanto-Axial Dislocation with Bilateral Vertebral Artery Transection

Published on: 2016-03-18


Traumatic atlantoaxial dislocation is an uncommon injury with high mortality. Blunt vertebral artery transaction is also rare and is universally fatal. We report the clinical and radiographic findings of a case of traumatic atlantoaxial dislocation with bilateral vertebral artery transaction, an injury rarely seen in the hospital. We also review the literature on the incidence and association of these injuries with an emphasis on the difficulty in diagnosis and need for a high index of suspicion to allow for attempts at intervention to prevent permanent neurologic damage. A 20-year-old male was struck by a car and presented to our level I trauma center. Following initial resuscitation, he underwent neck CT angiography which revealed the injuries. These findings are incompatible with life and care was withdrawn shortly after the diagnosis was made.