FACTSvery rare traumatic fracturesAnderson and Montesano classifications/ HPI PHYSICAL EXAMuniversal neuro examevaluate for lower cranial nerve palsies (CN 12 most commonly involved)IMAGINGMRI Cervical spine w/o contrast to assess for ligamentous integrity/epidural/subdural hematomaA/PStabilizationRigid C-collar at all times for at least 6 weeksFusion/Halo considered if O-C1 interval > 2mmEagle SignFigure 1: Eagle Sign of occipital condyle and jugular tubercule