Traumatic atlanto-occipital dislocation carries a significant mortality and morbidity. We present the clinical and radiological features of a case of traumatic skeletal and central nervous system disunion. Thanks to a combination of early resuscitation and luck, the patient survived an improbably severe injury to leave hospital and enjoy a degree of independent life. Such severe injuries are usually fatal and the literature on such extensive cervical disruption is often confined to postmortem evidence.