[A new osseous malformation of the cervico-occipital joint. Fusion of the anterior arch of the atlas and corpus of the axis (author's transl)].
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Biomedical subjects
Publications and source records attributed to A Wackenheim.
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The diagnosis of space-occupying lesions in the subtentorial space by vertebral angiography is based upon a good knowledge of arteries and veins and topographic points of this region. An imaginary line between the colliculo-central point and the chorioidal point divides the posterior fossa into two imaginary parts. In this way it is possible to localize displacements in the region of the posterior fossa. Of course, the displacement of the veins and arteries is very important in the verification of the tumours. Consequently, vertebral angiography is of vital importance in the investigation of space-occupying lesions in the posterior fossa.
The author describes a conical sub-dural space above the vermis limited in front by Galien's ampulla, behind by the right venous sinuses and, below by the superior cerebellar vein. This space, which is not filled with air injected by the cisternal route, is only shown in lateral views thanks to its venous outlines. In cases of raised intracranial pressure, the superior cerebellar vermis may occupy this space so that a sort of impaction occurs at this level, which the author proposes calling smaller than superior vermial impaction greater than. Among forms of cerebral herniation, vermial impaction may not occur when the CSF obstruction occurs at another level.
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