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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Upper and lower motor neuron palsies Cranial nerve palsies Cerebellar symptoms Epilepsy Intellectual disability Always associated with encephalocele. This prospective study analyzes patients with Chiari malformation and primary craniovertebral junction CVJ anomalies years.

This term has been used to denote a separate piece of bone present posterior to the anterior arch of atlas. When the basiocciput and rim of foramen magnum are underdeveloped, the odontoid and arch of atlas may grow normally to over hang along the sides. Certain cranioverttebral are conventionally used to express the anomalies, as follows 1. Medical College and K. Mesodermal somites numbering 42 appear at the 4th week. Blood supply thro’ the body anomlies axis is limited due to interposition of cartilage between body and the odontoid process.

Craniovertebral anomalies.

A-A dislocation is the commonest abnormality, be it congenital or acquired. Clinical science The craniovertebral junction CVJ is composed of the occiput, the foramen magnumand the first two cervical vertebrae, encompassing the medulla oblongata and the upper cervical spinal cord.


Mirror movements of the hands are often seen in klippel Feil syndrome due to inadequate decussation of pyramidal tract at medulla. In the absence of strong reasons to consider embryological basis, traumatic theory is more rationale. Mal aligned bony components of the spinal canal compress underlying cord due to dislocation of the joints, the commonest is Atlanto ankmalies dislocation.

An analysis based on surgical cases. Proatlas remnants were identified in 8 and atlas assimilation in 92 patients. Surgical treatment for Arnold Chiari malformation associated with atlantoaxial dislocation. A study based on surgically treated cases. CV anomalies are defects of development, not necessarily congenital and may not manifest at birth.

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.

If the dislocation is sudden and severe, an acute quadriparesis may occur. ahomalies

Published by Wolters Kluwer – Medknow. In course of time the dislocation may become fixed leading to progressive deficit.

However its occurrence along with other CV anomalies is frequent. In certain diseases craniovertenral bone like hyperparathyroidism, pagets or osteomalacia, there is softening of the base of skull which gets invaginated. Plate and screw fixation for atlanto-axial dislocation. Features of type I CM In addition, caudal displacement of a beaked dorsal midbrainand possibly the fourth ventricle.


Gallow popularized the technique of midline wiring which kept the atlas and axis is opposition.

The critical sagittal canal diameter at the foramen magnum was 19 mm. Caudal half joins with cephalic half of adjacent sclerotome – future vertebra. Open access journal indexed with Index Medicus.

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The soft tissue details can be imaged with a high degree. Von Torklus Anpmalies, Gehle W. Symptoms of lower brain stem dysfunction, such as dysphagia, dysphonia, nasal regurgitation, sleep apnoea are due to basilar invagination. Click on image for details.

The Upper Cervical Spine: Occipito-atlantal dislocation is rare. This was the beginning. Correlation of anatomic and neurologic anomaoies. Hartshell frame is still being used by many. There is male preponderance 1: Dens lacks a good nutrient artery.

Craniovertebral anomalies.

In basilar invagination, there is crowding of structures in the small post. Treatment of basilar invagination by atlantoaxial joint distraction and direct lateral mass fixation.

All these methods are effective when reduction of dislocation is adequate. In early stages of A-A dislocations, most of them are reducible and require only stabilization.