Occipital condyle fractures diagnosed by high-definition CT and coronal reconstructions

We describe four cases of fracture of the occipital condyle. In all cases plain cervical spine films were normal. The fracture was diagnosed on the lowest section of a routine CT examination of the head. Further detail was then obtained with high-definition CT and coronal reconstructions. All the patients were found to have a small atlanto-occipital subluxation, no greater than 11 mm. Classification and treatment of these fractures is discussed. It is stressed that the lower-most section of a CT head study for cerebral trauma should include the inferior margin of the foramen magnum and that both bone and soft tissue images should be obtained.