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At least 181 records · Page 10Linked to original sources
PubMed2000

Stroke following appendectomy under general anesthesia in a patient with basilar impression.

We report a boy who developed a vertebral stroke immediately after an appendectomy. Basilar impression was diagnosed eight years after this event when skull roentgenograms revealed basilar impression with high standing tip of the odontoid. We speculate that muscle relaxation and cervical hyperextension during intubation in the presence of basilar impression resulted in vertebral artery dissection and stroke. We suggest that patients with vertebral stroke and no obvious risk factors should be evaluated for the presence of malformations of the craniovertebral junction to be able to take precautions against excessive neck movement during intubation.

Anesthesia, General↗
PubMed1989

[Sudden deafness and the craniocervical transition].

Morphological alterations of the cranio-cervical junction as a basilar impression, a ponticulus posterior, an atlas assimilation, an intervertebral narrowing, and spondylosis deformans were found radiologically. There was no difference to a healthy population. This means there are no correlations between static morphological changes of the craniocervical junction and sudden deafness. However, there was a statistically significant reduced mobility in the upper cervical spine in patients suffering from sudden deafness. Especially very high standard deviations in the atlanto-occipital and the atlanto-dental joint are interpreted as hypermobile as well hypomobile atlas joints. These results indicate a correlation between sudden deafness and functional pathology of the craniocervical junction.

Adult↗
PubMed1989

[Indications and technic of transoral dens resection in craniocervical dysplasia].

Compressive lesions of the brain stem caused by ventrally or dorsally located bony malformations of the posterior skull base and the upper cervical spine show diffuse neurological signs and symptoms. They can imitate multiple sclerosis, cerebellar tumours, Ménière's disease and "Ménière-like" otological symptoms. Therefore, the otologist is involved in diagnosis and therapy of cranio-cervical dysplasia. At present dysplasia is differentiated into an anterior and posterior form of the disease. The most common lesion in the anterior form is brain stem compression by the high located dens axis. Therefore, transoral surgical removal of the dislocated odontoid process is the logical form of treatment and should be performed in patients with severe complaints. The technique used for the transoral resection of the odontoid process is described in detail. In 7 patients having the anterior type of the cranio-cervical dysplasia we performed a transoral resection of the elevated odontoid process. The results obtained were convincing with all patients. No intraoperative or postoperative complications were seen. Hearing impairment was not changed, neurological deficits and particularly vertigo improved. Follow-up examinations did not show any disturbances of head movements or remarkable dislocations of the kraniozervikal joints.

Adult↗
PubMed1992

Basilar impression and Arnold-Chiari malformation. Surgical findings in 209 cases.

The surgical findings observed in a series of 209 consecutive patients with craniovertebral anomaly are presented. The high prevalence of basilar impression in the Northeast of Brazil is noteworthy. There were 28 (13.3%) patients with basilar impression alone, 10 (4.7%) cases of pure Arnold-Chiari malformation and in 171 (81.8%) cases the basilar impression was associated with Arnold-Chiari malformation. This study reflects our surgical experience of the pathology in a 17-year period (1971-1987). It reflects also the peculiarities of neurosurgical practice in an undeveloped region of this Country. The literature is extensively reviewed.

Adolescent↗
PubMed1999

Transmaxillary anterior decompressions in patients with severe basilar impression.

Severe basilar impression leads to an upward translocation of the upper cervical spine and clivus into the foramen magnum and is a diagnosis best made with computed tomography or magnetic resonance imaging scans. Basilar impression may be a primary condition or secondary to bone softening disorders. Symptoms relating to direct neuraxial compression, obstruction to cerebral spinal fluid outflow, and vascular compromise all have been described. Management depends on the exact nature of the abnormality seen, but it is now firmly accepted that those with anterior neuraxial compression should have an anterior decompression. The severe basilar impression and craniofacial abnormalities seen in osteogenesis imperfecta together with the progressive nature of the condition have led to the development of a specific surgical response, the open door maxillotomy combined with a contoured loop fixation of the cervical spine. Little is known of the long term outcome of severe basilar impression, and long term studies undertaken by centers familiar with the condition and its management are required if definitive care is to be delivered to these patients.

Decompression, Surgical↗
PubMed1984

MR imaging of familial basilar impression.

Basilar impression was found in three members of one family. The mother showed an asymptomatic deformity, her eldest son complained of headache, drop-attacks, nystagmus, unilateral ophthalmoplegia, and ataxia; the middle son presented with headache, nystagmus, and hemiparesis. Magnetic resonance (MR) imaging demonstrated convexobasia of various degrees with elevation of the upper spine and malformation of the occipital bone. The medulla oblongata and the pons were flattened and dislocated backward in two cases. Chiari malformation was present in one case and mild hydrocephalus in another. A comparison of MR with CT imaging demonstrates some advantages of the former method in the assessment of the neural structures directly involved in basilar impression.

Adult↗
PubMed1990

The operative management of basilar impression in osteogenesis imperfecta.

Four patients with osteogenesis imperfecta and neurologically significant basilar impression have been treated over the past 8 years. The experience has resulted in changes in our therapeutic strategy for this particularly difficult problem. These cases are discussed with respect to the disease process, neurological involvement, radiological findings, and modes of surgical therapy. The errors in management as well as the success resulting from our learning experience are described. Currently, we recommend the extensive removal of the anterior bony compression by a transoral approach. This should be followed by a posterior rigid fixation that transfers the weight of the head to the thoracic spine, in an effort to prevent further basilar invagination.

Adult↗
PubMed1991

Transoral decompression evaluated by cine-mode magnetic resonance imaging: a case of basilar impression accompanied by Chiari malformation.

Cine-mode magnetic resonance imaging provides simultaneous images of cerebrospinal fluid flow dynamics. A patient with a basilar impression accompanied by a Chiari malformation and von Recklinghausen's disease who underwent transoral decompression is reported. Preoperative cine-mode magnetic resonance imaging visualized an associated obstruction of cerebrospinal fluid pulsatile flow at the level of the foramen magnum. Tonsilar herniation (Chiari I malformation) and hydrocephalus were also present. Postoperatively, the obstruction of cerebrospinal fluid flow was resolved concomitant with the correction of the cervicomedullary angulation. On the basis of observations made by magnetic resonance imaging, the surgical treatment of basilar impression accompanied by Chiari malformation is briefly discussed.

Adult↗