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The patient is 43 year old gentleman, who was assaulted and placed in a head lock 2 months ago. He said he heard something "crack" in his neck. He immediately had severe neck pain, and difficulty swallowing over the first few days, but denied any weakness. Over the following weeks he developed weakness in his upper and lower extremities that evolved to the point that he lost his ability to ambulate, and was admitted to the public hospital in Managua, Nicaragua.Imaging studies showed atlantoaxial instability from midsubstance transverse ligament tear.For additional imaging studies please go tohttp://www.orthobullets.com/cases/view?id=3629a3ea-9f00-48aa-933f-0740abd2234f
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