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The Angle Orthodontist Jan 2008Three cases of abnormal incidental findings on lateral cephalogram are presented. These patients reported for orthodontic consultation in their adolescence. While...
Three cases of abnormal incidental findings on lateral cephalogram are presented. These patients reported for orthodontic consultation in their adolescence. While studying the patients' cephalograms, abnormal radiographic findings were discovered in their cervical vertebrae. Because the patients were asymptomatic, early diagnosis based on these radiographic findings made the patients aware of the situations. Lifestyle changes were instituted with specialist consultation in two patients to prevent or delay the onset of symptoms of an underlying pathology. Patients were educated about the likely future course of these findings. Specialist follow-up was advised to all the patients.
Topics: Adolescent; Atlanto-Occipital Joint; Axis, Cervical Vertebra; Cephalometry; Cervical Atlas; Cervical Vertebrae; Female; Humans; Incidental Findings; Malocclusion; Odontoid Process; Platybasia; Radiography; Synostosis
PubMed: 18193959
DOI: 10.2319/091306-370.1 -
Journal of Neurology, Neurosurgery, and... Apr 1976Syncope precipitated by sneezing in an adult male associated with an Arnold-Chiari type I malformation and basilar invagination presents a clinical problem in the...
Syncope precipitated by sneezing in an adult male associated with an Arnold-Chiari type I malformation and basilar invagination presents a clinical problem in the differential diagnosis and pathological anatomy of Valsalva-related syncope. An abnormally acute clivoaxial angle, small foramen magnum, and type I Arnold-Chiari malformation appear to be a combination of features intolerant of Valsalva-induced changes in cerebral volume, brain-stem position, CSF fluid dynamics, or blood vessel relationships. Proposed mechanisms of pressure transmission to the area of intracranial pathology are discussed.
Topics: Adult; Arnold-Chiari Malformation; Humans; Male; Platybasia; Radiography; Skull; Sneezing; Syncope
PubMed: 932754
DOI: 10.1136/jnnp.39.4.381 -
Thorax Oct 1987Previous work confirmed the abnormal potential difference between the undersurface of the inferior nasal turbinate and a reference electrode in cystic fibrosis, but the...
Previous work confirmed the abnormal potential difference between the undersurface of the inferior nasal turbinate and a reference electrode in cystic fibrosis, but the technique is difficult and the results show overlap between the cystic fibrosis and the control populations. In the present study the potential difference from the floor of the nose has therefore been assessed in normal subjects, as well as in adult patients with cystic fibrosis, bronchiectasis and Young's syndrome. Voltages existing along the floor of the nasal cavity were recorded. The mean potential difference was similar in controls (-18 (SD 5) mv) and in patients with bronchiectasis (-17 (6) mv) and Young's syndrome (-20 (6) mv). The potential difference in cystic fibrosis (-45 (8) mv) was significantly different from controls (p less than 0.002) and there was no overlap between the cystic fibrosis values and values obtained in normal and diseased controls. This simple technique therefore discriminates well between patients with cystic fibrosis and other populations, raising the possibility of its use to assist in diagnosis.
Topics: Adolescent; Adult; Amyotrophic Lateral Sclerosis; Bronchiectasis; Cystic Fibrosis; Female; Humans; Male; Membrane Potentials; Nose; Platybasia; Syndrome
PubMed: 3424257
DOI: 10.1136/thx.42.10.815 -
Arquivos de Neuro-psiquiatria Nov 2014
Topics: Headache; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Odontoid Process; Physical Exertion; Platybasia; Tomography, X-Ray Computed; Torticollis
PubMed: 25410463
DOI: 10.1590/0004-282x20140163 -
Journal of Neurology, Neurosurgery, and... Mar 1999To describe the clinical and neuroradiological features of basilar impression in patients with osteogenesis imperfecta type IV.
OBJECTIVES
To describe the clinical and neuroradiological features of basilar impression in patients with osteogenesis imperfecta type IV.
METHODS
Four patients with basilar impression were ascertained in a population study of osteogenesis imperfecta. All four had detailed clinical and neuroradiological examination with both CT and MRI of the craniocervical junction and posterior fossa structures.
RESULTS
All four showed significant compression of the posterior fossa structures and surgical decompression was performed with relief of symptoms.
CONCLUSION
Symptoms of cough headache and trigeminal neuralgia occurring in patients with osteogenesis imperfecta are indications for detailed clinical and neuroradiological investigation to document basilar impression.
Topics: Adolescent; Adult; Brain; Female; Humans; Male; Osteogenesis Imperfecta; Platybasia; Tomography, X-Ray Computed
PubMed: 10084535
DOI: 10.1136/jnnp.66.3.357 -
Arquivos de Neuro-psiquiatria Sep 2013The prime objective in the surgical treatment of basilar impression (BI), Chiari malformation (CM), and/or syringomyelia (SM) is based on restoration of the normal...
The prime objective in the surgical treatment of basilar impression (BI), Chiari malformation (CM), and/or syringomyelia (SM) is based on restoration of the normal cerebrospinal fluid (CSF) dynamics at the craniovertebral junction and creation of a large artificial cisterna magna, avoiding the caudal migration of the hindbrain. It is observed that a large craniectomy might facilitate an upward migration of the posterior fossa structures. There are many surgical techniques to decompress the posterior fossa; however, a gold standard approach remains unclear. The authors present the results of 192 cases of BI, CM, and SM treated between 1975 and 2008 and whose surgical treatment was characterized by a large craniectomy without tonsillectomy with the patient in the sitting position, large opening of the fourth ventricle, and duraplasty.
Topics: Adolescent; Adult; Aged; Arnold-Chiari Malformation; Child; Child, Preschool; Craniotomy; Dura Mater; Female; Fourth Ventricle; Humans; Male; Middle Aged; Platybasia; Retrospective Studies; Syringomyelia; Treatment Outcome; Young Adult
PubMed: 24141441
DOI: 10.1590/0004-282X20130105 -
European Spine Journal : Official... Sep 2008Chiari I malformations are often associated with congenital craniocervical anomalies such as platybasia, basilar invagination, and retroflexion of the odontoid process....
Chiari I malformations are often associated with congenital craniocervical anomalies such as platybasia, basilar invagination, and retroflexion of the odontoid process. Management of ventral brain stem compression associated with Chiari I malformations remains controversial, but several authors report a significant rate of failure with suboccipital decompression alone in the presence of pronounced ventral brain stem compression (VBSC). Treatment options described in the literature for these patients involve anterior, posterior, or combined decompressions with or without concurrent arthrodesis. A combined anterior and posterior approach provides a definitive circumferential decompression but also significantly disrupts the stability of the occipitocervical junction usually necessitating occipitocervical fixation. We describe an alternative surgical treatment for Chiari I patients with significant ventral brain stem compression where a combined anterior and posterior decompression was considered necessary. We report two patients who underwent transoral odontoidectomy with preservation of the anterior arch of the atlas and suboccipital craniectomy with C1 laminectomy followed by C1-C2 arthrodesis. Preservation of the anterior arch of the atlas in conjunction with C1-C2 arthrodesis stabilizes the occipito-atlanto-axial segments while conserving more cervical mobility as compared to an occipitocervical fusion.
Topics: Adolescent; Adult; Arnold-Chiari Malformation; Atlanto-Axial Joint; Atlanto-Occipital Joint; Brain Stem; Cervical Vertebrae; Female; Humans; Laminectomy; Odontoid Process; Radiography; Skull; Spinal Cord Compression; Spinal Fusion
PubMed: 18629549
DOI: 10.1007/s00586-008-0706-x -
Neurologia Medico-chirurgica Nov 1991Anterior or posterior decompression of the foramen magnum was performed in three patients with syringomyelia associated with basilar impression and Chiari I...
Anterior or posterior decompression of the foramen magnum was performed in three patients with syringomyelia associated with basilar impression and Chiari I malformation. The operative results were evaluated using the pre- and postoperative magnetic resonance (MR) images. Two patients with combined anterior and posterior cervicomedullary compression due to basilar impression and tonsillar descent received suboccipital craniectomy, upper cervical laminectomy, and dural plasty without any intradural manipulations via the posterior approach. One patient with prominent anterior cervicomedullary compression due to basilar impression and a sharp clivoaxial angle was operated on by the transoral anterior approach. Postoperatively, all patients showed a sustained shrinkage of the syrinx and rounding of the flattened cerebellar tonsils. Two patients showed upward movement of the herniated tonsils. All patients had improved symptoms during 2-4 years follow-up. Treatment of syringomyelia associated with basilar impression and Chiari I malformation requires more efficient decompressive procedures at the foramen magnum based on neurological and MR findings.
Topics: Adult; Arnold-Chiari Malformation; Child; Female; Follow-Up Studies; Foramen Magnum; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Platybasia; Syringomyelia
PubMed: 1723159
DOI: 10.2176/nmc.31.715 -
European Spine Journal : Official... Aug 2010
Response to the expert's comment of P. Suchomel concerning grand rounds case entitled "Syringomyelia with irreducible atlantoaxial dislocation, basilar invagination and Chiari I malformation", Eur Spine J, Vol 19, no 3, 2010: pp 367-369 (by Shenglin Wang et al.).
Topics: Arnold-Chiari Malformation; Atlanto-Axial Joint; Humans; Joint Dislocations; Odontoid Process; Platybasia; Syringomyelia
PubMed: 20407793
DOI: 10.1007/s00586-010-1397-7 -
European Spine Journal : Official... Mar 2010
Expert's comment concerning Grand Rounds case entitled "Syringomyelia with irreducible atlantoaxial dislocation, basilar invagination and Chiari I malformation" (by Shenglin Wang, Chao Wang, Ming Yan, Haitao Zhou, Liang Jiang).
Topics: Adult; Arnold-Chiari Malformation; Atlanto-Axial Joint; Female; Humans; Joint Dislocations; Platybasia; Syringomyelia
PubMed: 20238471
DOI: 10.1007/s00586-009-1209-0