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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]
  • 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]
  • A case is presented of a 35-year-old woman diagnosed with platybasia associated with Klippel-Feil syndrome type I.[ncbi.nlm.nih.gov]
  • The authors present the case of a 16-year-old boy affected by HCS. On initial magnetic resonance (MR) imaging, a severe basilar invagination with Chiari malformation and cervicothoracic syringomyelia was documented.[ncbi.nlm.nih.gov]
Saddle Nose
  • Trigonocephaly Craniofacial dysostosis : Crouzon syndrome Hypertelorism Hallermann–Streiff syndrome Treacher Collins syndrome other: Macrocephaly Platybasia Craniodiaphyseal dysplasia Dolichocephaly Greig cephalopolysyndactyly syndrome Plagiocephaly Saddle[en.wikipedia.org]
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]
  • 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]
  • 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]
  • Therapy Surgical therapy Asymptomatic patients who are diagnosed of Chiari type I malformation without syringomyelia should not be considered as candidates for surgery.[bmcmusculoskeletdisord.biomedcentral.com]
Arachnodactyly
  • […] recurvatum Discoid meniscus Congenital patellar dislocation Congenital knee dislocation foot deformity : varus Club foot Pigeon toe valgus Flat feet Pes cavus Rocker bottom foot Hammer toe Either / both fingers and toes Polydactyly / Syndactyly webbed toes Arachnodactyly[en.wikipedia.org]
Tooth Loss
  • It is characterized by facial dysmorphism, premature tooth loss, osteolysis of distal phalanges, and skull abnormalities.[ncbi.nlm.nih.gov]
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[karger.com]
  • These abnormalities can result in neck pain; syringomyelia; cerebellar, lower cranial nerve, and spinal cord deficits; and vertebrobasilar ischemia. Diagnosis is by MRI or CT.[merckmanuals.com]
  • 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]
  • Neck pain is frequent and characterized by the absence of radicular distribution. It is associated to continuous, burning, deep-seated discomfort in the shoulders, nape, chest, and upper limbs. Neck pain usually increases with Valsalva manoeuvres.[bmcmusculoskeletdisord.biomedcentral.com]
Genu Valgum
  • valgum Genu varum Genu recurvatum Discoid meniscus Congenital patellar dislocation Congenital knee dislocation foot deformity : varus Club foot Pigeon toe valgus Flat feet Pes cavus Rocker bottom foot Hammer toe Either / both fingers and toes Polydactyly[en.wikipedia.org]
  • valgum , Genu varum ) Arthrogryposis[bionity.com]
Hip Dislocation
  • […] abnormality ( Q65–Q76 , 754–756.3 ) Appendicular limb / dysmelia Arms clavicle / shoulder : Cleidocranial dysostosis Sprengel's deformity Wallis–Zieff–Goldblatt syndrome hand deformity : Madelung's deformity Clinodactyly Oligodactyly Polydactyly Leg hip[en.wikipedia.org]
  • Limbs hip : Dislocation of hip / Hip dysplasia feet ( Club foot , Flat feet , Pes cavus ) head , face, spine and chest: skull , face and jaw ( Dolichocephaly , Plagiocephaly ) - Scoliosis - chest ( Pectus excavatum , Pectus carinatum) Polydactyly/ Syndactyly[bionity.com]
Foot Deformity
  • deformity : varus Club foot Pigeon toe valgus Flat feet Pes cavus Rocker bottom foot Hammer toe Either / both fingers and toes Polydactyly / Syndactyly webbed toes Arachnodactyly Cenani–Lenz syndactylism Ectrodactyly Brachydactyly Clubbed thumb reduction[en.wikipedia.org]
Coxa Valga
  • valga Coxa vara knee : Genu valgum Genu varum Genu recurvatum Discoid meniscus Congenital patellar dislocation Congenital knee dislocation foot deformity : varus Club foot Pigeon toe valgus Flat feet Pes cavus Rocker bottom foot Hammer toe Either / both[en.wikipedia.org]
Diplopia
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]
  • A short neck, craniofacial asymmetry, and kyphoscoliosis are common associated features. The foramen magnum is often deformed to varying extents.[rrnursingschool.biz]
  • A short neck and flat skull base are often visible on inspection. Hypernasal speech, i.e. velopharyngeal insufficiency, with or without palatal clefts is an occasional clue. The neurologicalsigns [ 11 ] are notably variable.[karger.com]
  • This is attributed to a short neck, large tongue, prominent occiput, fragile mandible & cervical spine and predisposition to mucosal bruising and broken teeth.[ispub.com]
  • These include short neck, torticollis, platybasia, cervical vertebral body fusion (Klippel-Feil abnormality) including assimilation of atlas, spondylotic spinal changes, and restriction of neck movements.[jcvjs.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]
  • Tingling down the back, often into the legs, with neck flexion (Lhermitte sign) may occur. Uncommonly, pain and temperature senses (spinothalamic tract function) are impaired in a stocking-glove pattern.[merckmanuals.com]
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]
Spastic Quadriplegia
  • Spastic quadriplegia can result from platybasia. Basilar invagination or compression of posterior fossa structures may lead to cerebellar or brainstem compressive syndromes.[emedicine.medscape.com]
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]

Treatment

  • Subsequent refinement of radiology facilitated diagnosis and the later advent of surgical treatment.[ncbi.nlm.nih.gov]
  • 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]
  • This approach will enable the practitioner to make the most accurate diagnosis and choose the most effective treatment option.[books.google.com]
  • Chapters focus on specific disorders or groups of disorders and emphasize differential diagnosis, disease course, treatment, and prognosis. This edition has a new chapter on mitochondrial cytopathies.[books.google.com]

Prognosis

  • Chapters focus on specific disorders or groups of disorders and emphasize differential diagnosis, disease course, treatment, and prognosis. This edition has a new chapter on mitochondrial cytopathies.[books.google.com]
  • 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]
  • The prognosis for patients with Paget disease who have giant cell tumors usually is good. High doses of steroids have been shown to reduce tumor mass. Radiation and surgery also have been used to treat symptomatic giant cell tumors.[emedicine.medscape.com]
  • 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

  • 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-aps.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]
  • 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]
  • It was suggested by many that as basilar invagination has several etiologies it should be considered a radiographic finding and the underlying etiology should be identified.[jcvjs.com]
  • […] neurologic consequences Platybasia (flattening of the skull base so that the angle formed by the intersection of the clival and anterior fossa planes is 135 ), seen on lateral skull imaging: Usually, no symptoms or cerebellar or spinal cord deficits Etiology[merckmanuals.com]

Epidemiology

  • Overview Chiari malformations Definition : caudal displacement of the cerebellum with/without the medulla oblongata , through the foramen magnum , due to CVJ anomalies Epidemiology Associations Neural tube defects (esp. meningomyelocele ) Syringomyelia[amboss.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]
  • […] displacement of the cerebellum with/without the medulla oblongata , through the foramen magnum , due to CVJ anomalies Epidemiology Associations Neural tube defects (esp. meningomyelocele ) Syringomyelia Hydrocephalus Klippel-Feil syndrome Basilar invagination Pathophysiology[amboss.com]
  • The pathophysiology of arthritic changes associated with Paget disease is unknown. Enlargement of joints and altered biomechanics may cause abnormal stress across joints, giving rise to degenerative changes.[emedicine.medscape.com]
  • Pathophysiological considerations, based on observations on three related cases. Acta Neurochir (Wien). 1995, 137: 38-43. 10.1007/BF02188778.[bmcmusculoskeletdisord.biomedcentral.com]

Prevention

  • 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]
  • SECURITY The law establishes an obligation to adopt security measures to prevent the unauthorized access to the computer database containing personal data or damage to the integrity or quality of the data.[institutchiaribcn.com]

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