Radek Kaiser, Hossein Mehdian

February 2021, Volume 30, Issue 2, pp 381 - 384 Grand Rounds Read Full Article 10.1007/s00586-014-3360-5

First Online: 13 June 2014


Craniocervical pneumatisation [inline-graphic not available: see fulltext] of both occiput and upper cervical vertebrae is extremely rare. Although it was stated that hyperpneumatisation can lead to fracture, only few cases of such injuries have been reported. Generally, craniocervical fractures represent a small number of cervical spine injuries and they are usually caused by high-energy trauma and can be associated with lower cranial nerves palsy.

Case report

We present here a case of healthy man with mostly left sided pneumatisation of occiput and C1 who suffered from fractures of occipital condyle and posterior arch of C1 associated with permanent hypoglossal nerve injury. Both fractures were stable and he was treated conservatively with a rigid collar.


At follow-up, the patient reported no pain and no restriction in head movement. Total hypoglossal nerve palsy remained unchanged. Conservative treatment is a method of choice in such cases.

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