This is a report of a series of 14 patients who presented with a range of 'atypical' cranial, spinal and systemic symptoms that started after they suffered relatively severe injury to the head and/or neck several months or years prior to the surgical treatment. Implications of diagnosing and treating central or axial atlantoaxial instability (CAAD) is discussed. Role of dynamic rotatory and lateral head tilt imaging in the diagnosis and treatment is analysed. There were 7 males and 7 females and their ages ranged from 21 to 64 years (average 42 years). Due to the severity of presenting neurological and non-neurological symptoms, all patients lost their occupation and were heavily dependent on painkillers and/or antidepressant drugs. In addition to other tell-tale clinical and radiological evidence, diagnosis of CAAD was made based on facetal alignments on lateral profile imaging in neutral head position. Dynamic head flexion-extension, lateral head tilt and neck rotation imaging confirmed and subclassified CAAD. All patients underwent atlantoaxial fixation surgery. A personalized self-assessment clinical scoring parameter and the WHODAS 2.0 was used to evaluate the outcome. One patient did not follow-up after surgery. At a minimum follow-up of 6 months after atlantoaxial fixation surgery, there was relief from all major symptoms in the rest of 13 patients. Diagnosing and treating CAAD can have 'major' therapeutic implications in patients presenting with progressively worsening disabling clinical symptoms following relatively severe head/neck trauma.