Complete disruption of the C4/5 and anterior and posterior longitudinal ligaments. This is associated with extensive thickening of the prevertebral soft tissues. A small epidural haematoma extends from the C4/5 level, down to C6, without evidence of cord compression. Widening of the C4/5 facet joints with associated interspinous ligament damage, not only at this level, but also at the level above and below. A flow void in the left vertebral artery is not visible, instead high signal is seen along its length (including V4) consistent with dissection and thrombosis.