A. Schoeggl et al., A lateral mass fracture of C1 associated with left vertebral artery and mid-basilar artery occlusion, J NEUROTRAU, 18(7), 2001, pp. 737-741
Extreme acceleration and deceleration forces as well as axial loading are e
xerted at the occipito-cervical junction of drivers involved in high-veloci
ty motor vehicle accidents, especially with fastened seatbelts. Injury at t
his level, usually lethal, can go unrecognized despite modern emergency man
agement of the unconscious patient. A precise neurologic and radiographic w
orkup of damage to this area is often not possible or overlooked in the ini
tial phase of such severe trauma. We describe a patient with multiple injur
ies who sustained a left vertebral artery occlusion associated with a left-
sided lateral mass fracture of C1 and a basilar artery occlusion resulting
in a locked-in syndrome after an automobile accident.