Communicating hydrocephalus, basilar invagination, and. All structured data from the file and property namespaces is available under the creative commons cc0 license. Typically, cranial settling occurs when a degenerative process erodes the lateral masses of the atlas and axis, leading to superior migration of the odontoid fig. Full texthtml download pdf 1596k download meta ris compatible with endnote, reference manager, procite, refworks. Ebraheims educational animated video describes the basilar impression, and its radiological interpretation, along with explanatory images. Primary basilar impression genetic and rare diseases. Excerpt basilar impression known also as basilar invagination and platybasia are not synonymous nor need they necessarily be coexistent simultaneously or otherwise. Basilar definition of basilar by the free dictionary.
Basilar impression an overview sciencedirect topics. Most patients with atlas assimilation are asymptomatic, but some may present with neurological problems such as myelopathy. Full text full text is available as a scanned copy of the original print version. It also may press on the lower brainstem this is similar to chiari malformation. It is seen in diseases such as rickets, osteogenesis imperfect, hyperparathyroidism, hurlers syndrome, pagets disease and acroosteolysis hajducheney syndrome. But precisely, basilar impression is defined as upward displacement of c2 into the normal foramen magnum with normal bone, while basilar invagination is a similar displacement due to softening of bones at the base of the skull. A more precise method to differentiate between these types of cvjm is desirable. A basilar impression in some cases may not produce untoward symptoms during the entire life of the individual. Basilar impression is a malformation or deformation of the cranial base consisting of indentation of. The term basilar impression often called basilar invagination is generally used to broadly label different types of deformities involving the posterior cranial fossa and the upper cervical vertebra. Clinical signs and symptoms may include weakness, neck pain, myelopathyspasticity, ataxia, swallowing difficulty, and other lower cranial nerve deficits. A bizarre developmental anomaly of the occipital bone and upper cervical spine with striking and misleading neurologic manifestations. We present the case of a 37yearold woman who presented with neck and occipital pain, episodic neck stiffness, and dizziness.
Osteogenesis imperfecta oi is anecdotally associated with macrocephaly, hydrocephalus, basilar invagination, and cerebral atrophy, but the frequency and the spectrum of neurologic features of this condition are poorly defined. Basilar impression complicating osteogenesis imperfecta. This can cause compression of the spinal cord and brainstem. Basilar impression in an 8yearold male spineuniverse. Basilar impression is caused by this deformation resulting from softening of the bone as opposed to basilar invagnation wherein the bone is normal. Basilar invagination variably associated with symptoms, brainstem compression. Chiari malformations cms and basilar invagination bi bi1 and bi2 are the most common craniocervical junction malformations ccjm seen in adults. Basilar impression presenting as intermittent mechanical. 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. Basilar impression is an acquired type of basilar invagination. Basilar invagination, basilar impression, and platybasia. There is basilar impression along with the aad in this case. Basilar impression financial definition of basilar impression.
This is mainly seen in cases of hyperparathyroidism, rheumatoid arthritis or rickets. The mean age of patients requiring surgical decompression is 43 years for basilar impression and 22 years for basilar invagination. One of the most common causes of this deformity is an abnormal structure of the skeleton. Basilar impression occurs when parts of the cervical neck vertebrae enter the hole in the skull base foramen magnum. Bi is an uncommon syndrome that occurs when the upper part of the odontoid dens migrates upward towards the foramen magnum. Platybasia and basilar invagination fulltext european neurology. Links to pubmed are also available for selected references. This may occur from an accident, chronic bone disease, e. The periforaminal components of the occipital bone, and later the petrous portions of the temporal bones, are invaginated upward in such a manner as to diminish the volume of the posterior. Pbi can be asymptomatic or associated with severe neurological dysfunction.
A bizarre developmental anomaly of the occipital bone and upper. There is upward displacement of vertebral elements into a normal foramen magnum. Neuroimaging studies demonstrated sulcal prominence and ventriculomegaly consistent. We emphasize the importance of basilar impression in the differential diagnosis of menieres disease. Basilar invagination is invagination infolding of the base of the skull that occurs when the top of the c2 vertebra migrates upward. Basilar impression is the term used to describe the acquired form of basilar invagination or cranial settling. We speculate that muscle relaxation and cervical hyperextension during intubation in the presence of basilar impression resulted in vertebral artery dissection and stroke.
Primary basilar impression pbi is a very rare skeletal developmental defect characterized by congenital upward translocation of the upper cervical spine and clivus into the foramen magnum. The more impressions an ad receives, the more likely it is that a user will click on it. Patients may be asymptomatic or complain of headaches, neck pain, cough, trigeminal neuralgia, limb weakness, altered muscle reflexes, quadriparesis, nystagmus, and ataxia. Basilar impression may be either congenital or acquired. Proper imaging studies as well as recognizing often. Stroke following appendectomy under general anesthesia in. Chiari malformation and types of basilar invagination with. Odontoid tip lying above this line is indicative of type. Basilar invagination is the same problem, except that its caused by softening in the bones at the skull base.
Neck pain, basilar impression, craniovertebral congenital anomalies, red flags, physiotherapy. Basilar impression or basilar invagination occurs when there is an abnormal upward displacement of the basilar and condylar portions of the occipital bone. Vertebral artery dissection related to basilar impression. The diagnosis of basilar impression is based on lateral xray films of the skull base, tomography of this region, and in some cases on computerized axial tomography. Wed like to understand how you use our websites in order to improve them. Request pdf basilar impression and invagination basilar impression secondaryacquired and invagination primary develop when the odontoid process of c2 migrates into the foramen magnum. Briefly, basilar impression or basilar invagination is a deformity of the osseous structures at the base of the skull in the region of the foramen magnum. It is seen compressing the medulla resulting in significant white matter edema. Platybasia is an anthropologic term describing flattening of the skull base and should not be used synonymously with basilar invagination. In many cases, an insidious headache is the only symptom and can be a diagnostic challenge for the neurologist.
Lateral tomogram case 19 showing elevation of the odontoid andanterior arch ofthe atlas. We report our experience with 76 patients with oi seen at nih. Craniometric studies have shown that both chiari malformation cm and basilar invagination bi belong to a spectrum of malformations. The terms basilar invagination and basilar impression are often used interchangeably because in both cases there is upwards migration of the upper cervical spine, but they are not synonyms. Basilar impression article about basilar impression by. Get a printable copy pdf file of the complete article 1. Complete atlantooccipital assimilation with basilar. Basilar impression, the most common malformation of the craniocervical junction, 1 is a wellrecognized cause of neck pain, hydrocephalus, cerebellar dysfunction, cough, headache, lower cranial nerve palsies, corticospinal signs, syringomyelia, and syringobulbia, as first reported by homen 2 in 1901. Anteroposterior tomogram case 19 showing elevation of the occipitoatlantoid joints and the odontoid, also fusion ofc4and5.
Of, relating to, or located at or near the base, especially the base of. Basilar impression, the most often occurring malformation of the craniocervical region, is the upward displacement of basilar and condylar portions of the occipital bone causing an infolding of the foramen magnum and leading to a translocation of the upper cervical spine into the brainstem. Basilar invagination, also called basilar impression, is a congenital or acquired craniocervical junction abnormality where the tip of the odontoid process projects above the foramen magnum terminology. Pdf basilar impression presenting as intermittent mechanical neck. Since 1939, when chamberlain 1 focused attention on the pathologic complex of basilar impression and its concomitant neurologic manifestations, a dozen or more american observers have reported a total of 19 verified cases in which the condition masqueraded as a variety of syndromes. The cranial migration of dens is suggestive of basilar impression. The two vertebral arteries and the basilar artery are sometimes together called the vertebrobasilar system, which supplies blood to the posterior part of the circle of willis and joins with blood supplied to the anterior part of the. Basilar invagination, a rare condition mimicking posterior circulation stroke. Pdf basilar invagination is an abnormality at the craniovertebral junction, either congenital or degenerative. Basilar invagination, basilar impression, and cranial. This leads to invagination of the foramen magnum into the posterior cranial fossa with associated translocation of. Basilar invagination is a developmental anomaly of the craniovertebral junction in which the odontoid abnormally prolapses into the foramen magnum. Basilar impression and platybasia in pagets disease 1 maxwell h.
Files are available under licenses specified on their description page. Diagnostic criteria of basilar impression radiology. Basilar invagnation and basilar impression both can cause potential compression of the brainstem. Basilar definition is of, relating to, or situated at the base. The odontoid process invagination in normal subjects. Chaudhry ns, ozpinar a, bi wl, chavakula v, chi jh, dunn if, basilar invagination. Basilar invagination an overview sciencedirect topics.
A rare case of basilar impression bmj case reports. Basilar impression presenting as intermittent mechanical neck pain. A short neck and flat skull base are often visible on inspection. Basilar invagination occurs when the upper portion of the cervical vertebra moves upward and posteriorly within the skull. In addition, a manual search of all referenced articles not found in the search was performed. Basilar impression and platybasia in pagets disease. Pdf neurofibromatosis, stroke and basilar impression. This is a pdf file of an unedited manuscript that has been accepted for publication.
Basilar impression was diagnosed eight years after this event when skull roentgenograms revealed basilar impression with high standing tip of the odontoid. Atlantooccipital assimilation is a partial or complete congenital fusion between the atlas and the base of the occiput. Basilar impression definition of basilar impression by. Basilar invagination or basilar impression occurs where there is upward migration of the base of the skull. Basilar definition of basilar by medical dictionary.
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