Introduction to CNS Imaging, Trauma

(Left) Bone CT with sagittal

reformatting shows that the

anteroposterior alignment of

the cervical spine appears

normal. However, there is

increased distance between

the occipital condyle and C1

lateral mass ſt as well as

widening of the C1-C2

articulation st. (Right)

Sagittal STIR scan in the same

patient shows how MR better

depicts soft tissue injuries.

Widened occipital condyle-C1

and C1-C2 articulations with

hyperintensity in both joints

ſt and posterior ligamentous

C2-C4 injury st are present.

(Left) Lateral radiograph of

the upper cervical spine shows

malalignment with the

spinolaminar line of C1 ſt in

front of C2 and C3 st.

Lucencies through the

posterior C1 ring are fractures

﬇. (Right) Coronal

reformatted bone CT shows

coronal displacement of both

C1 lateral masses ſt. Also

seen is a bony fragment due to

transverse ligament tubercle

avulsion st.

(Left) Sagittal graphic shows

an unstable cervical

hyperflexion injury with

disruption of the anterior ſt

and posterior

﬈ longitudinal

ligaments as well as the

interspinous ligament ﬇,

traumatic disc herniation st,

epidural hemorrhage, and cord

injury. (Right) Sagittal

reformatted bone CT of a

cervical spine fracture in a

patient with ankylosing

spondylitis nicely shows the

bone injuries ſt but does not

depict the extent of soft tissue

damage. MR is complementary

to multiplanar CT.

Trauma, and Stroke

Brain: Pathology-Based Diagnoses: Malformations,

37