Type III occipital condylar fracture presenting with hydrocephalus, vertebral artery injury and vasospasm: case resort

Occipital condylar fractures (OCF) are rare and have a high mortality rate. We report a patient with OCF who presented with acute hydrocephalus and di ed from diffuse vasospasm secondary to vertebral artery injury. A 45-year-o ld man fell 20 feet from a deer stand and landed on his head. CT showed a t ype III OCF continuing to the anterior rim of the foramen magnum on the lef t, with a bone fragment pushing into the medulla, causing hydrocephalus. Th e patient was stabilized, and a four-vessel arteriogram showed diffuse vaso spasm with complete occlusion of the left vertebral artery at the level of the OCF. To our knowledge, this is the first documented case of the conjunc tion of OCF, hydrocephalus, and vasospasm.