Bilateral Epitransverse and Paracondylar Processes: A Rare Craniocervical Junction Variant

The craniocervical junction is a complex anatomic structure that connects the skull to the cervical spine while allowing movement and protecting critical neurovascular structures. Variants in the junction, such as paracondylar and epitransverse process anomalies, may disrupt its mechanics and impact both movement and structural integrity. Although often asymptomatic, these anomalies may cause pain due to premature atlantodental arthritis and complicate surgeries by obscuring landmarks. Surgical resection may be considered in symptomatic cases to alleviate pain and functional limitations. We report the case of a 38-year-old man who presented to the emergency department after a motor vehicle accident. Craniocervical CT revealed no signs of trauma but showed a rare anatomic variant involving bilateral epitransverse and paracondylar processes.