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Current Pain and Headache Reports Aug 2016The congenital and acquired deformities of the craniovertebral junction (CVJ), such as basilar invagination, basilar impression, or platybasia, can present in the form... (Review)
Review
The congenital and acquired deformities of the craniovertebral junction (CVJ), such as basilar invagination, basilar impression, or platybasia, can present in the form of slowly progressive or acute neurologic deterioration. In many cases, an insidious headache is the only symptom and can be a diagnostic challenge for the neurologist. Proper imaging studies as well as recognizing often associated neurologic or systemic conditions are required for early diagnosis and effective therapy. In the current report, the primary focus will be on clinical aspects of these CVJ abnormalities; the pathologic and radiologic aspects, such as developmental and pathophysiologic background or radiographic analysis, will be discussed briefly, confined to clinically relevant data.
Topics: Atlanto-Occipital Joint; Headache; Humans; Platybasia
PubMed: 27344347
DOI: 10.1007/s11916-016-0580-x -
Journal of Neurology, Neurosurgery, and... Feb 1949
Topics: Humans; Occipital Bone; Platybasia
PubMed: 18111230
DOI: 10.1136/jnnp.12.1.61 -
European Neurology 2007Descriptions of the flattening (platybasia) of the skull base and the upward displacement(impression) of the basilar and condylar portions of the occipitalbone by the...
Descriptions of the flattening (platybasia) of the skull base and the upward displacement(impression) of the basilar and condylar portions of the occipitalbone by the upper cervical spine date to the late 18th and early 19th centuries. Anatomical measurements to display these abnormalities were begun in 1865, but the full clinical significance was not appreciated until Homen's work in 1901. Subsequent refinement of radiology facilitated diagnosis and the later advent of surgical treatment.
Topics: History, 18th Century; History, 19th Century; History, 20th Century; Humans; Middle Aged; Neurology; Odontoid Process; Platybasia; Skull
PubMed: 17483591
DOI: 10.1159/000102172 -
AJNR. American Journal of Neuroradiology Jan 2005Platybasia, or abnormal obtuseness of the basal angle, was first measured on plain skull images. At present, evaluation of the brain and skull more commonly involves CT... (Comparative Study)
Comparative Study
BACKGROUND AND PURPOSE
Platybasia, or abnormal obtuseness of the basal angle, was first measured on plain skull images. At present, evaluation of the brain and skull more commonly involves CT and MR imaging. We evaluated a new MR imaging method of evaluating platybasia.
METHODS
We retrospectively evaluated midline sagittal MR images in 200 adults and 50 children. The basal angle of the skull base was measured by using two methods: The standard MR imaging technique measured the angle formed by two lines-one joining the nasion and the center of the pituitary fossa connected by a line joining the anterior border of the foramen magnum and center of the pituitary fossa. The modified technique measured the angle formed by a line across the anterior cranial fossa and dorsum sellae connecting a line along the clivus.
RESULTS
With the standard MR imaging technique, we obtained mean angles of 129 degrees +/- 6 degrees for adults and 127 degrees +/- 5 degrees for children, compared with 135.3 degrees (composite mean) in previous series. The modified technique produced values of 117 degrees +/- 6 degrees for adults and 114 degrees +/- 5 degrees for children, which were significantly lower that those of standard MR imaging and traditional radiography (P <.05).
CONCLUSION
Both the standard and modified MR imaging techniques produced basal angles lower than those previously reported with standard radiography. The modified technique uses clearly featured landmarks that can be reproduced consistently on midline sagittal T1 images. This technique and its corresponding values can be used as the new standard for evaluating the basal angle.
Topics: Adult; Cephalometry; Child; Cranial Fossa, Posterior; Foramen Magnum; Humans; Image Enhancement; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Platybasia; Retrospective Studies; Sella Turcica; Sensitivity and Specificity; Skull Base
PubMed: 15661707
DOI: No ID Found -
The Cleft Palate-craniofacial Journal :... Sep 2013Objectives : To estimate the prevalence of platybasia in patients with velopharyngeal incompetence (VPI) and its relation with palatal anomalies and syndromes. Design...
Objectives : To estimate the prevalence of platybasia in patients with velopharyngeal incompetence (VPI) and its relation with palatal anomalies and syndromes. Design and Settings : Retrospective case analysis. Setting : A university-affiliated hospital. Patients : The VPI patients (n = 366) included five groups with either cleft lip and palate (CLP), cleft palate (CP) only, submucous cleft palate (SMCP), occult submucous cleft palate (OSMCP), or non-CP. The control group (n = 126) comprised healthy, normal-speech individuals. Outcome Measures : The cranial-base angle was measured by lateral cephalometric radiography. The prevalence of platybasia (defined as cranial base angle ≥ 137°) was estimated and the patient's syndromes were recorded. Results : The prevalence of platybasia was significantly higher in the VPI group (28.7%) than in the normal controls (2.4%) (P < .001). A significant difference (P < .01) was found in the prevalence of platybasia among the five VPI groups: 16.7%, 20.3%, 28.8%, 33.7%, and 40.3% for CLP, CP only, SMCP, OSMCP, and non-CP, respectively. No significant difference was found between the cranial-base angle of VPI patients and of controls and between the cranial-base angle of the five VPI groups. The VPI nonplatybasic patients had a significantly smaller cranial-base angle than normal controls (P < .01). Platybasia was the highest among patients with velocardiofacial syndrome (50%), followed by those with Pierre Robin syndrome (27.3%). Conclusions : Platybasia, which may cause enlargement of the nasopharyngeal space and difficulties in achieving velopharyngeal closure, can be found in high numbers of VPI patients with or without CP. This supports the belief that velopharyngeal anomaly may be part of a more complex craniofacial anomaly influenced by the cranial-base flexure.
Topics: Cleft Palate; Humans; Platybasia; Prevalence; Retrospective Studies; Velopharyngeal Insufficiency
PubMed: 23002914
DOI: 10.1597/11-265 -
Surgical Neurology Jan 2007Vascular compression of the trigeminal nerve is generally accepted as the primary source causing TN. To date, skull base bone deformity associated with ITN has been...
BACKGROUND
Vascular compression of the trigeminal nerve is generally accepted as the primary source causing TN. To date, skull base bone deformity associated with ITN has been reported in only a number of case reports. The aim of the present study was to investigate one such skull base deformity, platybasia, in ITN patients in comparison with a randomized control population.
METHODS
Basal angle values reflecting the development of platybasia were measured in 25 patients with ITN and compared with the measurements in 25 control subjects.
RESULTS
Basal angle measured to investigate the existence of platybasia was found significantly wider in the ITN group (t = 3.90; P < .001), although platybasia was present in only 10 patients. Moreover, the average angle was also greater in the study group than in the control group, and the difference was statistically significant. Platybasia was found in 10 patients, whereas it was detected in only 2 control individuals; difference in platybasia incidence between the 2 groups was also statistically significant (chi(2) = 7.01; P < .01).
CONCLUSION
Our data demonstrated that platybasia affecting the bony walls of the posterior fossa may play an important role in the pathogenesis if vascular abnormalities causing TN.
Topics: Aged; Aged, 80 and over; Case-Control Studies; Female; Humans; Incidence; Male; Middle Aged; Occipital Bone; Platybasia; Prospective Studies; Radiography; Sella Turcica; Trigeminal Neuralgia; Turkey
PubMed: 17210309
DOI: 10.1016/j.surneu.2006.08.021 -
A.M.A. Archives of Ophthalmology Jul 1954
Topics: Arnold-Chiari Malformation; Congenital Abnormalities; Humans; Occipital Bone; Platybasia; Vision, Ocular
PubMed: 13170861
DOI: 10.1001/archopht.1954.00920050015002 -
Neurosurgery Clinics of North America Jul 2015Odontoidectomy is the treatment of choice for irreducible ventral cervical-medullary compression. The endonasal endoscopic approach is an innovative approach for... (Review)
Review
Odontoidectomy is the treatment of choice for irreducible ventral cervical-medullary compression. The endonasal endoscopic approach is an innovative approach for odontoidectomy. The aim of this article is to identify in which conditions this approach is indicated, discussing variants of the technique for selected cases of craniovertebral malformation with platybasia. We believe that the technical difficulties of this approach are balanced by the advantages for patients. Some conditions related to the patient and to the anatomy of the craniovertebral junction may favor adoption of the endoscopic endonasal approach, which should be considered complementary and not alternative to standard approaches.
Topics: Cervical Vertebrae; Decompression, Surgical; Humans; Natural Orifice Endoscopic Surgery; Neuroendoscopy; Nose; Odontoid Process; Patient Selection; Platybasia; Spinal Cord Compression; Treatment Outcome
PubMed: 26141361
DOI: 10.1016/j.nec.2015.03.002 -
Journal of Neurosurgery Aug 2005Hadju-Cheney syndrome (HCS) is a rare autosomal-dominant disorder with variable expressivity. It is characterized by facial dysmorphism, premature tooth loss, osteolysis... (Review)
Review
Hadju-Cheney syndrome (HCS) is a rare autosomal-dominant disorder with variable expressivity. It is characterized by facial dysmorphism, premature tooth loss, osteolysis of distal phalanges, and skull abnormalities. In some cases, progressive platybasia can occur and can lead to Chiari malformation with an obstruction of cerebrospinal fluid flow. To the best of the authors' knowledge, only five cases of HCS-associated syringomyelia have been reported in the literature. Because of the rarity of this association, little is known about its natural history. The authors present the case of a 16-year-old boy affected by HCS. On initial magnetic resonance (MR) imaging, a severe basilar invagination with Chiari malformation and cervicothoracic syringomyelia was documented. The syringomyelia had no clinical manifestations. A repeated MR image demonstrated a spontaneous resolution of the syrinx with no changes in the tonsil or the platybasia. The regression of the syringomyelia was confirmed by a control MR imaging examination performed after a 2-year period. No changes in the patient's clinical conditions were found during the follow-up period. This is the first case of spontaneous regression of the syringomyelia despite a severe platybasia in HCS. It did not appear correlated to a modification of the tonsil's structure or position. This observation illustrates one possible evolution of syringomyelia in the natural history of HCS and raises the question of the potential mechanisms involved in the spontaneous drainage of the syringomyelic cavity.
Topics: Adolescent; Arnold-Chiari Malformation; Follow-Up Studies; Hajdu-Cheney Syndrome; Humans; Magnetic Resonance Imaging; Male; Platybasia; Remission, Spontaneous; Syringomyelia; Tomography, X-Ray Computed
PubMed: 16370291
DOI: 10.3171/ped.2005.103.2.0194 -
Neuroimaging Clinics of North America Nov 2021The skull base is a critical structure in the craniofacial region, supporting the brain and vital facial structures in addition to serving as a passageway for important... (Review)
Review
The skull base is a critical structure in the craniofacial region, supporting the brain and vital facial structures in addition to serving as a passageway for important structures entering and exiting the cranial cavity. This paper will review and highlight some of the embryology, developmental anatomy, including ossification, and related abnormalities of the anterior, central and posterior skull base using illustrative cases and tables. Pathologies such as dermoids/epidermoids, cephaloceles, nasal gliomas, glioneuronal heterotopias, various notochordal remnants, persistent craniopharyngeal canal, teratomas, platybasia, basilar invagination, clival anomalies and Chiari malformations will be discussed. Developmental pearls and pitfalls will also be highlighted.
Topics: Arnold-Chiari Malformation; Diagnostic Imaging; Humans; Platybasia; Skull; Skull Base
PubMed: 34689936
DOI: 10.1016/j.nic.2021.06.004