n SA Journal of Radiology - Trauma imaging of the cranio-cervical junction : diagnosis : quiz case

Volume 16, Issue 4
  • ISSN : 1027-202X
  • E-ISSN: 2078-6778



A 5-year-old boy presented to A&E with quadriparesis after a motor vehicle accident. Initial plain radiographs were normal. The CT images of the cranio-cervical junction (CCJ) obtained on admission showed a large acute prepontine retroclival extradural haematoma (REH). There is posterior displacement of the tectorial membrane and compression of the lower pons and medulla. No fractures of the clivus or the upper cervical vertebrae is noted. The cranio-cervical junction bony elements retain their normal alignment with preservation of the powers ratio.

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