Siemionow and Chou review the surgical management of atlantoaxial instability in the context of Down syndrome, using two interesting illustrative cases with different craniocervical abnormalities (atlantoaxial rotatory subluxation and os odontoideum). Both patients present with significant craniocervical spinal cord compression, and in this context, they highlight the specific case nuances that...

OBJECTIVE The aim of this study was to perform a detailed tomographic analysis of the skull base, craniocervical junction, and the entire spine in seven patients with spondylocostal dysostosis syndrome. METHOD Detailed scanning images have been organized in accordance with the most prominent clinical pathology. The reasons behind plagiocephaly, torticollis, short immobile neck, scoliosis and ...

A 68-year-old male presented an unusual dural arteriovenous fistula (AVF) located at the craniocervical junction. Magnetic resonance imaging revealed dilated perimedullary veins around the spinal cord at C-1 and C-2 levels, as well as high intensity signals in the spinal cord on T2-weighted images. Vertebral angiography identified an AVF at the point where the right vertebral artery penetrates ...

130 CMYK Brain Surgery: complication avoidance and management. New York: Churchill Livingston; 1993. pp. 2221-44. 2. Kanaan IU, Ellis M, Safi T, Al Kawi MZ, Coates R. Craniocervical junction tuberculosis: a rare but dangerous disease. Surg Neurol 1999;51:21-5. 3. Selvapandian S, Chandy MJ. Tuberculous granuloma of the clivus. Br J Neurosurg 1993;7:581-2. 4. Sencer S, Sencer A, Aydin K, Hepgul K...

Rear-end impacts caused worse initial symptoms and specific clinical findings, not clearly distinguished from those occurring after frontal impacts. WAD III injuries, retro-orbital pain, and isolated contra-directional pro-/retraction pain occurred more frequently after rear-end impacts, indicating the importance of shear loads and craniocervical junction vulnerability. Head inward rotation dur...

A 3.5 year old boy with Morquio's disease was referred with a persisting left hemiparesis four months after a fall and was found to have craniocervical junction compression due to atlantoaxial subluxation and significant anterior soft tissue compression. Transient unconsciousness at the time of the fall was probably due to medullary concussion as a result of hyperextension, not a head injury. S...

We describe a rare case of a 30 year-old woman with intense vertiginous sensation, lack of body balance and a tendency to fall backwards, making it necessary for two people to sustain her. The magnetic resonance imaging of the craniocervical junction evidenced tonsilar herniation at the inferior level of C1, and during the operation performed in sitting position, we observed crowding of the cer...

• If there is clinical or radiographic suspicion of AOD, CT of the craniocervical junction is recommended. The CCI determined on CT has the highest diagnostic sensitivity and specificity for AOD among all radiodiagnostic indicators in pediatric patients. The utility of CCI in adult patients has not been reported. • A lateral cervical radiograph is recommended for the diagnosis of AOD. If a radi...

A rare case of the dural arteriovenous fistula at the craniocervical junction which stemmed from subarachnoid hemorrhage was reported with some exceptional neuroradiological images, which would be useful for the diagnosis. Besides, in the case of subarachnoid hemorrhage due to unknown origin this disease should be taken into consideration. Furthermore, the especial anatomical feature of this di...

Atlanto-occipital assimilation is one of the most common osseous anomalies observed at the craniocervical junction. Most patients with atlas assimilation show no symptom, but some have neurological problems such as myelopathy that may require surgical treatment. Occipitocervical fusion may be required if atlato-occipital assimilation is accompanied by occipito-axial instability. However, in cas...