The authors describe the case of a patient, a 33-year-old man, who presented with paresis of the hypoglossal nerve following an occipital condyle fracture. The patient, as a driver, was involved in a car accident and from the beginning he complained of neck pain. The diagnosis was established by CT examination as late as 72 hours after injury on the basis of clinical presentation (difficulty in swallowing, chewing and speaking due to impaired mobility of the left half of the tongue, with the left half showing a marked hypotrophy and muscle weakness). A conservative treatment was used - application of a rigid cervical collar for 3 months, which resulted in gradual neurological improvement.