We report a case of pneumatization of the upper cervical spine and the craniocervical junction, including the occipital bone, accompanied by extensive soft tissue emphysema. There was no history of trauma or surgery. Follow-up X-ray and CT demonstrated the development of those changes. A combination of a developmental abnormality and the unusual habit of frequent Valsalva's maneuvers may have l...

A 52-year-old man presented with a 2-year-history of recurrent torticollis and headache associated with physical exertion (including evacuation). His physical examination disclosed short neck and brachycephaly. Neuroimaging studies (Figures 1 and 2) revealed basilar invagination and brainstem compression without other craniocervical junction abnormalities or systemic diseases. Basilar invaginat...

BACKGROUND Previous studies found that the facet joint of the C1 vertebra were removed (C1 facetectomy) before extirpation from the extramedullary tumor in craniocervical junction, leading to postoperative upper cervical instability or deformity. Occipito-cervical fusion (OCF) is a demanding and morbid surgical procedure, which can be used in such patients. This study is to analyze the clinical...

The earliest anatomic description of abnormalities of the “occipital vertebrae” was attributed to Meckel in 1815 by Gladstone and Erickson-Powell (20). In 1830, Charles Bell first described the clinical and pathological development of “spontaneous atlantoaxial dislocations” resulting from destruction of the transverse ligament “that holds the process of the dentata in its place” (3). After this...

Dural ateriovenous fistula (DAVF) at the craniocervical junction is rare. We report a patient presenting with brainstem dysfunction as an uncommon onset. Brainstem lesion was suggested by magnetic resonance image study. Angiogram revealed a DAVF at a high cervical segment supplied by the meningeal branch of the right vertebral artery, with ascending and descending venous drainage. Complete obli...