Presentation
Right-sided neck pain and right-hand paresthesia.
Patient Data
Atlanto-axial assimilation involves the anterior arch and atlantooccipital joints. Posterior C1 arch fusion failure. Basilar invagination. Large cervical cord syrinx.
Atlanto-occipital assimilation and basilar invagination. The odontoid process is also posteriorly angulated superiorly with narrowing of the premedullary CSF cistern and deformation of the cervicomedullary junction. Cerebellar tonsillar descent of 3 mm (i.e. no Chiari malformation).
Large syrinx extending from C2 to C6. Right posterolateral cord high T2 signal at the C2 level.
No intervertebral disc herniation. Subaxial spinal canal and neural exit foramina are capacious.
Case Discussion
This is a case of atlanto-occipital assimilation with resulting basilar invagination associated with a large syrinx. Typical presentation at this age with symptoms of pain and paresthesia.
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