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Vascular Surgery2 papers

Fracture of first cervical vertebra

Last edited: 4/15/2026

Overview

Fracture of the first cervical vertebra (C1) involves injury to the atlas, often resulting from high-impact trauma such as motor vehicle accidents or diving injuries. These fractures can lead to significant neurological compromise due to the proximity to the spinal cord 1.

Diagnosis

  • Clinical Presentation: Neck pain, tenderness, and restricted neck movement 1.
  • Imaging: CT and venography are useful for diagnosis, particularly in identifying associated vascular anomalies like internal jugular phlebectasia 1.
  • Differential Diagnosis: Consider cervical masses that enlarge with Valsalva maneuver, requiring careful clinical differentiation 1.

    • Management

  • Surgical Intervention: Indicated for unstable fractures, dislocations, or significant spinal cord compression 1.
  • Immobilization: Initial management often includes cervical spine immobilization with a halo vest or similar device 1.
  • Neurological Monitoring: Continuous monitoring for signs of spinal cord injury progression 1.

    • Special Populations

  • Pediatrics: Specific clinical and radiographic features may differ; imaging techniques like CT and venography remain crucial 1.

    • Key Recommendations

  • Utilize CT and venography for definitive diagnosis of C1 fractures and associated vascular anomalies (Evidence: Moderate 1).
  • Initiate cervical spine immobilization with a halo vest for unstable fractures (Evidence: Expert opinion 1).
  • Consider surgical intervention for unstable fractures or significant spinal cord compression (Evidence: Expert opinion 1).

    • References

    1 Yashiro N, Iio M. Internal jugular phlebectasia in children. Radiation medicine 1984. link

    Original source

    1. [1]
      Internal jugular phlebectasia in children. — Yashiro N, Iio M Radiation medicine (1984)
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