PMC4416342_01
Laterolateral digital radiograph of the cervical vertebral column. The odontoid process (asterisk) is fractured and displaced but still remains attached to the body of the atlas. Notice the marked step misalignment between the fracture fragments and narrowing of the vertebral canal at this level.
13620_2015_34_Fig1_HTML.jpg
PMC4416342_01_13620_2015_34_Fig1_HTML.jpg
Fig1
Healthcare, Erlangen, Germany KV: 69,8, mAS: 25), identified a fractured odontoid process, which appeared to be still attached to the body of the atlas. However, dorsal dislocation of the C2 vertebral body was obvious (Figure 1).
Post-mortem sagittal T2W-image of the cervical vertebral column. The MRI revealed similar findings as the radiographs but displayed pronounced spinal cord involvement. The images reflect displacement of the C2 vertebral body with step misalignment of the vertebral canal and severe spinal cord compression at this level. Next to the compression site, the spinal cord (continuous arrows) shows a T2-hyperintense intramedullary signal. The considered differentials were spinal cord oedema, haemorrhage or myelomalacia. The T2-hyperintense area within the paravertebral musculature located dorsal to the fracture site (broken arrow) is indicative of a traumatic dorsal event. Asterisk = odontoid process.
13620_2015_34_Fig2_HTML.jpg
PMC4416342_01_13620_2015_34_Fig2_HTML.jpg
Fig2
C2 vertebral body and pronounced vertebral step misalignment (Figure 2). Cranial and caudal to the compression site, the spinal cord appeared swollen and exhibited a hyperintense intramedullary signal on the T2W-images and on the STIR-images, with mixed intensity (but predominantly hypointense appearance) on the T1W-images.
The fractured but normally developed odontoid process (asterisk) is highlighted by sagittal reconstruction of the post-mortem CT examination. The fracture site is located at the synchondrosis (S) between the base of the odontoid process and the body of the axis (C2). Comminuted bony fragments are visible ventrally in this aspect (arrow), and the odontoid process displacement was calculated to be 40% (see the calculation formula in the text). A = atlas.
13620_2015_34_Fig3_HTML.jpg
PMC4416342_01_13620_2015_34_Fig3_HTML.jpg
Fig3
CT images reflected MRI findings and furthermore identified the fracture site at the synchondrosis between the body of the axis and the odontoid process (Figure 3).