A unique association of Sturge-Weber syndrome and atlanto-occipital assimilation is presented. A 18-year-old male was admitted in emergency because of the sudden severe headache and vomiting. He had vascular nevus in the right half of the face at birth and several episodes of generalized convulsive seizures. On admission craniogram demonstrated calcification in the right occipital area. Neurological examination revealed tenderness in the nuchal region, moderate limitation of cervical mobility in a antero-posterior direction, Bruns-Cushing type nystagmus, bilaterally diminished gag reflex, and positive Romberg's test. Spinal tap showed crystal clear CSF with normal pressure. EEG showed paroxysmal slowing focus in the right parieto-occipital area. Polytomography of the craniovertebral junction demonstrated the unilateral atlanto-occipital assimilation on the left associated with the aplasia of the right posterior arch. Myelography was negative. A right carotid angiography disclosed the dilatation of the basal vein of Rosenthal and abnormal venous vasculature. CT-scan demonstrated the calcified region of the right occipital area more distinctly than the plain roentogenogram, but the enhancement study of the leptomeningeal angioma of the Sturge-Weber syndrome was negative. Never been found this rare association in a review of the literature, the authors discussed the clinical and radiological findings of both diseases.
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J Stroke Cerebrovasc Dis
December 2024
Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan; Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan.
Cureus
August 2024
Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
World Neurosurg
November 2024
Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India. Electronic address:
Chiari malformations, characterized by the herniation of cerebellar tonsils through the foramen magnum, are complex neurosurgical conditions that pose significant diagnostic and therapeutic challenges. Traditional interventions, such as foramen magnum decompression, have been the mainstay of treatment but are not universally effective, especially in cases with underlying atlantoaxial instability. However, recent studies highlight the importance of atlantoaxial instability in their pathogenesis, shifting the therapeutic focus towards atlantoaxial fixation.
View Article and Find Full Text PDFJ Clin Imaging Sci
July 2024
Department of Radiology, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong.
Atlanto-occipital assimilation is a congenital craniovertebral junction malformation where the partial or complete fusion of the atlas and occiput occurs. Atlanto-occipital assimilation can be associated with numerous complications, including basilar invagination, atlantoaxial subluxation, Chiari malformation, congenital vertebral bodies fusion, and cord compression. As a result, vigilant identification and accurate reporting of atlanto-occipital assimilation are essential.
View Article and Find Full Text PDFJ Orthop Case Rep
April 2024
Department of Orthopaedic Surgery, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil University, Pimpri, Pune, Maharashtra, India.
Introduction: Atlanto-occipital assimilation is the most common osseous anomaly of the cervical-occipital junction. The incidence rate of occipitalization has been reported 1.42.
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