Occipitocervical dissociation is reported in ∼1% of patients that present with cervical spinal trauma. The true incidence of this injury may be higher, as improved hemodynamic and respiratory instability management as well as the widespread use of cervical stabilization allows for a greater proportion of patients with this injury to survive through prehospital transport. 30 Injuries to upper cervical spine are very difficult to detect with plain radiographs due to parallax effect at the occipitocervical junction and obscuration by the mastoid air cells. As a result, CT is recommended for identifying these injuries.