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Transactions of the Ophthalmological... 1970
Topics: Adolescent; Adult; Central Nervous System Diseases; Eye Manifestations; Humans; Male; Nystagmus, Pathologic; Platybasia; Radiography; Skull
PubMed: 5283419
DOI: No ID Found -
Neurology May 1972
Topics: Adult; Brain Stem; Chromosome Aberrations; Chromosome Disorders; Humans; Male; Pedigree; Platybasia; Radiography; Syringomyelia
PubMed: 4673454
DOI: 10.1212/wnl.22.5.554 -
European Spine Journal : Official... Aug 2014Basilar invagination is a rare craniocervical malformation which may lead to neurological deficits related to compression of brainstem and upper cervical cord as well as...
PURPOSE
Basilar invagination is a rare craniocervical malformation which may lead to neurological deficits related to compression of brainstem and upper cervical cord as well as instability of the craniocervical junction. This study presents results of a treatment algorithm developed over a 20-year period focussing on anatomical findings, short-term and long-term outcomes.
METHODS
69 patients with basilar invagination (mean age 41 ± 18 years, history 64 ± 85 months) were encountered. The clinical courses were documented with a score system for individual neurological symptoms for short-term results after 3 and 12 months. Long-term outcomes were analyzed with Kaplan-Meier statistics.
RESULTS
Patients with (n = 31) or without (n = 38) ventral compression were distinguished. 25 patients declined an operation, while 44 patients underwent 48 operations. Surgical management depended on the presence of ventral compression and segmentation anomalies between occiput and C3, signs of instability and presence of caudal cranial nerve dysfunctions. 16 patients without ventral compression underwent foramen magnum decompressions without fusion. 19 patients with ventral compression and abnormalities of segmentation or evidence of instability underwent a foramen magnum decompression with craniocervical (n = 18) or C1/2 (n = 1) stabilization. In nine patients with severe ventral compression and caudal cranial nerve deficits, a transoral resection of the odontoid was combined with a posterior decompression and fusion. Within the first postoperative year neurological scores improved for all symptoms in each patient group. In the long-term, postoperative deteriorations were related exclusively to instabilities either becoming manifest after a foramen magnum decompression in three or as a result of hardware failures in two patients.
CONCLUSIONS
The great majority of patients with basilar invagination report postoperative improvements with this management algorithm. Most patients without ventral compression can be managed by foramen magnum decompression alone. The majority of patients with ventral compression can be treated by posterior decompression, realignment and stabilization alone, reserving anterior decompressions for patients with profound, symptomatic brainstem compression.
Topics: Adult; Algorithms; Decompression, Surgical; Female; Follow-Up Studies; Foramen Magnum; Humans; Infant; Male; Middle Aged; Platybasia; Radiography; Spinal Fusion; Young Adult
PubMed: 24938181
DOI: 10.1007/s00586-014-3423-7 -
Clinical Anatomy (New York, N.Y.) May 2018Although the embryology of the posterior cranial fossa can have life altering effects on a patient, a comprehensive review on this topic is difficult to find in the... (Review)
Review
Although the embryology of the posterior cranial fossa can have life altering effects on a patient, a comprehensive review on this topic is difficult to find in the peer-reviewed medical literature. Therefore, this review article, using standard search engines, seemed timely. The embryology of the posterior cranial fossa is complex and relies on a unique timing of various neurovascular and bony elements. Derailment of these developmental processes can lead to a wide range of malformations such as the Chiari malformations. Therefore, a good working knowledge of this embryology as outlined in this review of its bony architecture is important for those treating patients with involvement of this region of the cranium. Clin. Anat. 31:466-487, 2018. © 2018 Wiley Periodicals, Inc.
Topics: Animals; Arnold-Chiari Malformation; Cervical Vertebrae; Cranial Fossa, Posterior; Humans; Neural Crest; Osteogenesis; Platybasia; Skull
PubMed: 29345006
DOI: 10.1002/ca.23049 -
Canadian Medical Association Journal Nov 1951
Topics: Bone Diseases; Humans; Hydrocephalus; Occipital Bone; Osteitis Deformans; Platybasia; Skull
PubMed: 14879336
DOI: No ID Found -
Journal of Neurological Surgery. Part... Jul 2023There is evidence that Chiari malformation (CM) and basilar invagination (BI) are largely due to disproportion between the content and volume of the posterior fossa....
BACKGROUND
There is evidence that Chiari malformation (CM) and basilar invagination (BI) are largely due to disproportion between the content and volume of the posterior fossa. A recent study identified an increased association between brachycephaly and BI. In several types of craniosynostosis, the posterior fossa volume is smaller than normal, and this is more pronounced in coronal synostosis. The aim of this study is to evaluate the association between CM and BI.
METHODS
The cephalic index (CI) measured on magnetic resonance imaging (MRI) from a sample of patients with craniocervical malformation was compared with that of normal subjects.
RESULTS
The average CI in the craniovertebral junction malformation (CVJM) group was significantly higher in BI patients than in normal subjects. The BI patients also had the highest CI among the whole sample of patients ( = 0.009).
CONCLUSIONS
In this study, BI patients had the highest CI among patients with CVJM and a significantly higher CI than those in the control group. Our data confirm the association between BI and brachycephaly.
Topics: Humans; Platybasia; Arnold-Chiari Malformation; Magnetic Resonance Imaging; Craniosynostoses
PubMed: 34929749
DOI: 10.1055/s-0041-1739503 -
World Neurosurgery Aug 2022We sought to compare the diagnostic accuracy of cephalic indices for type B basilar invagination (BI).
OBJECTIVE
We sought to compare the diagnostic accuracy of cephalic indices for type B basilar invagination (BI).
METHODS
This retrospective study examined head and neck magnetic resonance imaging sequences of 31 Group B BI cases and 96 controls. Two examiners blinded to diagnostic data evaluated the cephalic indices of each magnetic resonance imaging sequence, described as width/length (WLI) and height/width (HWI). The distance of the odontoid process apex to Chamberlain line and clivus canal angle were measured. The interexaminer and intraexaminer reproducibility of the cephalic indices was calculated using intraclass correlation coefficient. The diagnostic accuracy was discerned by the receiver operating characteristic (ROC) curve. All analyses were scrutinized with a 95% confidence interval.
RESULTS
Cephalic indices showed interexaminer and intraexaminer reproducibility ≥94%. The areas under the ROC curve were 0.639 (WLI) and 0.874 (HWI) (95% confidence interval: P < 0.05). The HWI showed a sensitivity of 74.7% and a specificity of 85.5% for the cutoff criterion ≤58. The WLI presented a sensitivity of 53.3% and a specificity of 66.7% for the cutoff criterion ≥86.
CONCLUSIONS
The HWI showed the largest area under the ROC curve in comparison with the WLI, with robust sensitivity and specificity values, indicating that the proportions between cranial height and width can help clinicians in investigating type B BI.
Topics: Humans; Odontoid Process; Platybasia; ROC Curve; Reproducibility of Results; Retrospective Studies
PubMed: 35688370
DOI: 10.1016/j.wneu.2022.06.007 -
Neurosurgical Review Jan 2018Chiari malformation (CM) and basilar invagination (BI) are mesodermal malformations with disproportion between the content and volume of posterior fossa capacity and... (Meta-Analysis)
Meta-Analysis Review
Chiari malformation (CM) and basilar invagination (BI) are mesodermal malformations with disproportion between the content and volume of posterior fossa capacity and overcrowding of neural structures at the level of foramen magnum. Several alternatives for posterior approaches are available, including extradural (ED), extra-arachnoidal, and intradural (ID) approaches. The objectives are to evaluate the effect of several surgical techniques for posterior fossa decompression (PFD) in the outcomes of patients with CCJM and to evaluate complications in the techniques reported. A systematic review of the literature on the effects of PFD surgery was performed using the MEDLINE (via PubMed) database and the Cochrane Central Register of Controlled Trials. The PRISMA statement and MOOSE recommendations were followed. Five hundred and thirty-nine (539) articles were initially selected by publication title. After abstract analysis, 70 articles were selected for full-text analysis, and 43 were excluded. Ultimately, 27 studies were evaluated. The success rate (SR) with ED techniques was 0.76 versus 0.81 in EA technique and 0.83 in IA technique. All posterior fossa decompression techniques were very successful. Results from observational studies were similar to that of the randomized trial. The main complications were CSF fistulas, most common in patients with IA approach. The overall mortality rate was 1%.
Topics: Arnold-Chiari Malformation; Cranial Fossa, Posterior; Decompression, Surgical; Humans; Platybasia
PubMed: 28466256
DOI: 10.1007/s10143-017-0857-5 -
The Journal of Spinal Cord Medicine Nov 2022Spinal-generated movement disorders are a complex group of medical conditions, frequently misdiagnosed, originating in the spinal cord or from combined peripheral and...
CONTEXT
Spinal-generated movement disorders are a complex group of medical conditions, frequently misdiagnosed, originating in the spinal cord or from combined peripheral and central nervous system involvement. In this case report, we describe a novel form of position-dependent dyskinesia due to severe craniocervical malformation.
FINDINGS
An 83-year-old woman with basilar invagination at the C2 vertebra above the line of Chamberlain, occipitocervical lordosis, platybasia with a short clivus, ankylosis of the C1-C2 complex and fusion of the C1 arch developed an unusual pattern of position-dependent left arm dyskinesia triggered by bending her neck forward with simultaneous contact of the flexed elbow with a flat surface. Symptoms did not improve with anticonvulsants and she progressed and died suddenly.
CONCLUSION/CLINICAL RELEVANCE
A newly described form of position-dependent arm dyskinesia can be associated with severe craniocervical malformation.
Topics: Humans; Female; Aged, 80 and over; Arm; Spinal Fusion; Spinal Cord Injuries; Platybasia; Dyskinesias
PubMed: 33705252
DOI: 10.1080/10790268.2021.1878341 -
Lekarske Listy Sep 1954
Topics: Atlanto-Occipital Joint; Congenital Abnormalities; Humans; Mucopolysaccharidosis I; Physical Examination; Platybasia
PubMed: 13234627
DOI: No ID Found