Cranio-Vertebral AnomaliesDR. ANKUR NANDAN VARSHNEY IMS, BHU Varanasi. Cranio vertebral anomalies- overview -. 1. DR. SUMIT KAMBLE SENIOR RESIDENT DEPT. OF NEUROLOGY GMC, KOTA; 2. ANATOMY OF. The craniovertebral junction is the most complex of the axial skeleton, residing between the skull and the upper cervical spine. Congenital, developmental, and .

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Paramesial invagination was present in 20, syringohydromyelia in 46, and vertebral segmentation anokalies in 66 others. Regional Anatomy, Pathology, and Traumatology. In addition, the thick ligament and chronic granulation tissue which contribute to compression can be excised.

Craniovertebral junction anomalies – Knowledge for medical students and physicians

Goel A, Sharma P. Notochord disappears at the vertebral bodies, but persist as disc nucleus pulposus This membranous stage is followed by chondrification and ossification. Occasionally the foramen magnum may be narrowed or the rest of arch of the atlas may be deformed to cause compression of spino medullary junction.

In early stages of A-A dislocations, most of them are reducible and require ceaniovertebral stabilization.

Surgical treatment for Arnold Chiari malformation associated with atlantoaxial dislocation. Fatal meningitis, post operative dislocation are possible complications. Down syndromeachondroplasiaosteogenesis imperfecta Malignancies: Down’s syndrome lax joints. Online since 20 th March ‘ It encompasses and protects the medulla oblongata and the upper cervical spinal cord.

Features of type I CM In addition, caudal displacement of a beaked dorsal midbrainand possibly the fourth ventricle. J Postgrad Med ; It is generally accepted that a stabilization procedure is necessary following ant.


Physical appearance is often striking. Thus the atlas may get invaginated.

Platy basia alone not associated with other conditions does not produce any symptoms. Bony abnormalities in the region of foramen magnum: It could be partial or complex and may restrict occiptial movement. It occurs in 0.

Craniovertebral anomalies.

Out of 4 occipital sclerotomes the first 2 form basiocciputthe III Jugular tubercles and the IV Proatlas form parts of foramen magnum, atlas and axis. It is a complex process. Prepare and succeed on your medical exams. Goel A, Kulkarni AG.

Vertebral artery injury with transarticular screws letter. The anterior type has a short clivus horizontally placed, with the anterior lip of the foramen magnum invaginated in relation to the spinal column.

High arched palate, hemiatrophy of tongue, and syndactyly may craniovertebtal associated. Articles Current Issue Ahead ankmalies print Archive. The arch of the atlas, the odontoid and part of the axis can be excised.

The odontoid base fails to fuse with the axis.

Craniovertebral anomalies: Role for craniovertebral realignment Atul Goel Neurol India

In course of time the ligaments become lax and mobility increases predisposing to atlanto axial dislocation. Surgery is often indicated to prevent or treat neurological symptoms.

In the absence of strong reasons to consider embryological basis, traumatic theory is more rationale. Some feel a stabilization procedure is not required in selected cases. Type II Chiari malformation is a common anomaly ; 1 in 10, live births Sex: Ueber Verderbungen des Kleinhirns infolge von Hydrocephalie des Grossihirns. Sixty-six patients with irreducible pathology underwent ventral or ventrolateral decompression and dorsal stabilization. The wire retains an interposed only bone draft.

The abnormalities may have a familial occurrence. Lastly, associated Chiari malformation and syrinx may cause further neural compression.


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In case of disruption at crzniovertebral interface and if atlanto axial dislocation occurs, the remaining part of cranivoertebral odontoid may compress the cervico meduallary region. Click on image for details. In one series they affect children and young adults primarily.

Atlantoaxial fixation using plate and screw method: Acta Neurochir Wien ; Prevalence appears to be high as observed by neurosurgeons in India although it is yet to be corroborated by epidemiological studies.

Clivus segmentation Remnants around foramen magnum Basilar invagination Condylar hypoplasia Abnormal occipto atlantal ligament Malformation of atlas Failure of segmentation from occiput Atlanto axial fusion Aplasia of atlas arches. Operative treatment has involved thro’ several modifications. This membranous stage is followed by chondrification and ossification.

Screw fixation of facet junctions, Halifax clamps, contoured rods are the latest. Mesodermal somites numbering 42 appear at the 4th week Ventromedial part of the somatomes migrate and cluster around notochord- Sclerotomes A fissure in each sclerotome separate a denser caudal half from loosely arranged cranial half. This was the beginning.

Clinical features of CVJ anomalies are due to compression of the brain stem and the spinal cord and may include recurrent occipital headaches, neck aches, bulbar palsyand upper and lower motor neuron palsy. Though a number of bony and ligamentation anomalies have been described, consequences are mainly due to A A -A dislocation B malformed components of bone producing compression.