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Platybasia

Basilar Impression


Presentation

  • The aim of the present study was to investigate one such skull base deformity, platybasia, in ITN patients in comparison with a randomized control population.[ncbi.nlm.nih.gov]
  • Abstract 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.[ncbi.nlm.nih.gov]
  • The case is presented of a young boy with a family history of osteogenesis imperfecta tarda who suffered respiratory arrest during hospitalization. Cranial nerves and pyramidal tract signs were demonstrated.[ncbi.nlm.nih.gov]
  • Not only are the ocular signs and symptoms of these entities often the presenting complaints but, equally important, they simulate those of multiple sclerosis, tumor of the brain stem or cerebellum, and other lesions of the posterior fossa, which have[jamanetwork.com]
  • Abstract A case is presented of a 35-year-old woman diagnosed with platybasia associated with Klippel-Feil syndrome type I.[ncbi.nlm.nih.gov]
Asymptomatic
  • In most cases, subluxation less than this is asymptomatic. Lateral x-rays taken in extension and flexion are used to demonstrate AAS.[dizziness-and-balance.com]
  • Patients may be asymptomatic or complain of headaches, neck pain, cough, trigeminal neuralgia, limb weakness, altered muscle reflexes, quadriparesis, nystagmus, and ataxia.[rrnursingschool.biz]
  • Although asymptomatic patients are often followed conservatively, many authors favor surgery even if no symptoms of cord compression are evident in rheumatoid patients.[neuroradiologyonthenet.blogspot.com]
  • As an isolated finding, platybasia is not clinically important, and most patients are asymptomatic ( 13 ). When the basal angle is measured on lateral skull images, accurate X-ray techniques are essential for correct angles.[ajnr.org]
  • While it can be closely associated with basilar invagination and basilar impression, in isolation it is asymptomatic and essentially is a misused term when used to describe congenital defects.[statpearls.com]
Pathologist
  • Speech evaluation The speech-language pathologists in our multidisciplinary team are specialized in assessing cleft speech.[e-aps.org]
Painful Cough
  • Patients may be asymptomatic or complain of headaches, neck pain, cough, trigeminal neuralgia, limb weakness, altered muscle reflexes, quadriparesis, nystagmus, and ataxia.[rrnursingschool.biz]
  • Table 1 Basilar invagination: some radiological signs Basilar Impression or Invagination of the Skull Basilar invagination, the commonest malformation of the craniocervical junction [ 9 ], is a well recognised cause of neck pain, cough headache, lower[doi.org]
Neck Pain
  • Patients may be asymptomatic or complain of headaches, neck pain, cough, trigeminal neuralgia, limb weakness, altered muscle reflexes, quadriparesis, nystagmus, and ataxia.[rrnursingschool.biz]
  • Table 1 Basilar invagination: some radiological signs Basilar Impression or Invagination of the Skull Basilar invagination, the commonest malformation of the craniocervical junction [ 9 ], is a well recognised cause of neck pain, cough headache, lower[doi.org]
  • This can compress your spinal cord, causing neck pain, headache, balance problems, and even paralysis. While this condition may be congenital and the cause is unknown, people with Down syndrome have a higher risk for developing os odontoideum.[spineuniverse.com]
  • Those without the Chiari malformation mainly presented with weakness (100%), neck pain (59%), solely posterior column dysfunction (39%), bowel and bladder disturbance (28%), and paresthesia (25%).[statpearls.com]
Diplopia
  • The symptoms may also include clumsiness, numbness along one side of the body, unsteadiness of the gait, vertigo, weakness of one side of the body, loss of control of bowel and bladder, diplopia (double vision), periodic or constant cramping pain of one-sided[xpertdox.com]
Short Neck
  • Klippel-Feil syndrome type II is massive fusion of two of seven cervical vertebrae associated with short neck and low hair line.[ncbi.nlm.nih.gov]
  • She had blue sclera and short neck ( figure 1 ), right hypoglossal palsy, bilateral pyramidal tract signs, and gaze-evoked nystagmus.[n.neurology.org]
  • A short neck, craniofacial asymmetry, and kyphoscoliosis are common associated features. The foramen magnum is often deformed to varying extents.[rrnursingschool.biz]
Cleft Lip and-or Palate
  • However, young adults with repaired unilateral cleft lip and palate still have more obtuse cranial base angles than the control group [ 23 ], suggesting that no effect of surgical correction overcomes a congenitally obtuse angle.[e-aps.org]
Dizziness
  • She was admitted to University Department of Neurology for clinical examination because of walking difficulties, dizziness, and intermittent vision disturbances. Neurological examination revealed a predominance of cerebellar symptomatology.[ncbi.nlm.nih.gov]
  • Symptoms and signs also include posterior head pain, weakness of neck, periods of confusion, dizziness, sensory loss on the affected side of the body, cranial nerve disturbances, inability to know the positioning of joints, and electric shock sensation[xpertdox.com]
  • Patients with this syndrome have platybasia but do not have VPD; the symptoms that are attributed to platybasia include headaches, hydrocephalus, poor balance, dizziness, muscle weakness, decreased sensitivity to pain and temperature, and vision loss[e-aps.org]
Pyramidal Tract Signs
  • Cranial nerves and pyramidal tract signs were demonstrated. Roentgenograms showed severe basilar impression and hydrocephalus. Decompression of the brainstem and shunting were performed with improvement in the patient's neurological status.[ncbi.nlm.nih.gov]
  • She had blue sclera and short neck ( figure 1 ), right hypoglossal palsy, bilateral pyramidal tract signs, and gaze-evoked nystagmus.[n.neurology.org]
Hyperreflexia
  • According to Sawin and Menezes series in persons with osteogenesis imperfecta (1997), symptoms and signs included headache (76%), lower cranial nerve dysfunction (68%), hyperreflexia (56%), quadriparesis (48%), ataxia (32%), nystagmus (28%), and scoliosis[dizziness-and-balance.com]
Lhermitte's Sign
  • Lhermitte's sign (a tingling on neck movement, flexion in this case) can be demonstrated at any stage. A plain lateral x-ray, with odontoid views, is a good place to start, but is not 100% sensitive (Riew, Hilibrand et al. 2001).[dizziness-and-balance.com]
Trigeminal Neuralgia
  • Patients may be asymptomatic or complain of headaches, neck pain, cough, trigeminal neuralgia, limb weakness, altered muscle reflexes, quadriparesis, nystagmus, and ataxia.[rrnursingschool.biz]

Workup

Cervical Spine X-Ray
  • Relevant diagnostic work-up included craniogram, cervical spine x-ray, computed tomography (CT) of the brain and craniocervical junction, magnetic resonance imaging of the brain, electroencephalography, ophthalmologic examination, urinary tract ultrasonography[ncbi.nlm.nih.gov]

Treatment

  • Treatment: Unless there is impingement or compression of nerve roots or other neural tissue, no treatment is specifically indicated for platybasia; however, neural compression requires optimal treatment.[neurosurgery.ucla.edu]
  • Early recognition and implementation of aggressive treatment are important if irreversible neurological deficits are to be avoided.[ncbi.nlm.nih.gov]
  • Subsequent refinement of radiology facilitated diagnosis and the later advent of surgical treatment.[ncbi.nlm.nih.gov]
  • Discussions around the web We found 50 discussions Treato does not review third-party posts for accuracy of any kind, including for medical diagnosis or treatments, or events in general.[treato.com]
  • Subsequent refinement of radiology facilitated diagnosis and the later advent of surgical treatment. 2007 S.[doi.org]

Prognosis

  • In patients who are considered poor surgical risks, neurologic progression is likely and the one-year prognosis is poor. Neurosurgical treatment is quite difficult.[dizziness-and-balance.com]
  • Statistical analysis indicated that the cerebellar tonsillar descent (CTD) grade, basilar invagination and platybasia influenced the clinical outcome (P platybasia were indicated to be predictors of poor clinical prognosis.[science.gov]
  • Constantin Ionescu-Tirgoviste and Cristian Guja Resting metabolic rate in obese type 2 diabetic patients candidates for metabolic surgery 214 Anna Mirela Stroie and Mircea Penescu Adipose tissue mass and lean tissue mass predict medium-term outcome and prognosis[acad.ro]

Etiology

  • Many factors may contribute to the etiology of the VPD in 22q11DS [ 2 ]. An abnormally obtuse cranial base angle, also known as platybasia, is a common finding in 22q11DS [ 3, 4, 5 ].[e-aps.org]
  • The etiology of VPD in 22q11DS is multifaceted [ 2 ] and is likely to be a sum of many factors. Our findings indicate that platybasia does not play a prominent role in VPD.[e-sciencecentral.org]
  • This article reviews the etiology and manifesations of exertional, cough and sexual headeches and may be a helpful guide in identifying these syndromes in the clinical practice . CrossRef PubMed Google Scholar 22. Goel A.[link.springer.com]
  • Overview Etiology Congenital anomalies of the CVJ Acquired anomalies of the CVJ Trauma : to the bones or the supporting ligaments of the CVJ Inflammatory: rheumatoid arthritis, ankylosing spondylitis Genetic syndromes: Down syndrome, achondroplasia, osteogenesis[amboss.com]
  • What is the etiology of Os Odontoid(eum)? Etiology questionable, possibly congenital failure of fusion or a previously unrecognized fracture. What must be assessed with Os Odontoid(eum)? Integrity of the transverse ligament must be assessed.[quizlet.com]

Epidemiology

  • […] imperfecta Malignancies: chondrosarcoma, multiple myeloma, metastatic deposits References: [1] Chiari malformations Definition : caudal displacement of the cerebellum with/without the medulla oblongata, through the foramen magnum, due to CVJ anomalies Epidemiology[amboss.com]
  • Epidemiology Interestingly, the most common developmental abnormality at this site is atlantooccipital assimilation or occipitalization of the atlas, which frequently is noted in many other congenital anomalies.[statpearls.com]
  • 35 Elisa Mădălina Chirca, Rodica Luca and Georgescu Dan-Emil The prevalence of caries in first permanent molar in a group of school children aged 6 to 7 years in Piteşti 41 Flaviu Otniel Ciobotă, Gheorghe Cristea, Mariana Ioniţă and Ioan Liviu Mitrea Epidemiological[acad.ro]
Sex distribution
Age distribution

Pathophysiology

  • In the current report, the primary focus will be on clinical aspects of these CVJ abnormalities; the pathologic and radiologic aspects, such as developmental and pathophysiologic background or radiographic analysis, will be discussed briefly, confined[ncbi.nlm.nih.gov]
  • CVJ anomalies Epidemiology Incidence : Type I Chiari malformation is the most common anomaly; 1 in 1,000 live births Sex: Associations Neural tube defects (esp. meningomyelocele ) Syringomyelia Hydrocephalus Klippel-Feil syndrome Basilar invagination Pathophysiology[amboss.com]
  • Pathophysiology The basilar impression can be divided into two types: primary, which is the congenital defect that is frequently associated with syndromes and other vertebral abnormalities, and secondary which is attributed to development issues resulting[statpearls.com]
  • Pathophysiology of syringomyelia associated with Chiari I malformation of the cerebellar tonsils. Implications for diagnosis and treatment. J Neurosurg. 1994;80:3-15. [ Links ] .[scielo.br]

Prevention

  • […] which the odontoid process abnormally prolapses upward through the foramen magnum) 2 in OI results from abnormally soft bone at the cranio-cervical junction and the odontoid process protruding through the foramen magnum. 3 Appropriate screening may prevent[n.neurology.org]
  • In the series of Sawin and Menezes (1997), they suggest that ventral brainstem compression should be treated with ventral decompression, followed by occipitocervical fusion with contoured loop instrumentation to prevent further squamooccipital infolding[dizziness-and-balance.com]
  • Surgery is often indicated to prevent or treat neurological symptoms.[amboss.com]
  • To prevent the syrinx from expanding and harming your spinal cord, your doctor may perform surgery to remove the syrinx, though observation is a common treatment as well.[spineuniverse.com]
  • […] bone metabolic and functional impairments in children with cerebral palsy - preliminary results 137 Raluca Oana Munteanu, Emilia Rusu, Diana Simona Stefan and Gabriela Radulian Nutrition, physical activity and lifestyle factors in childhood obesity prevention[acad.ro]

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