A 4-year-old child in whom a penetrating trauma to an immature atlas led to an unusual disjunction of the posterior synchondrosis with atlas fracture displacement of the posterior “hemiarch” that plunged into the dura, resulting in a cerebrospinal fluid fistula.
Praneeth et al. discussed the possible mechanism and considerations in the management of this unique presentation. Such an atypical fracture pattern involving the posterior hemi ring of the pediatric atlas is previously unknown 1)