Abstract

Since 1939, when Chamberlain 1 focused attention on the pathologic complex of basilar impression and its concomitant neurologic manifestations, a dozen or more American observers have reported a total of 19 verified cases in which the condition masqueraded as a variety of syndromes. The literature on the subject has been reviewed by several of these authors, who credited Rokitansky with having first mentioned the deformity, in 1844. Homen, 2 in 1901. and Schuller, 3 in 1911, correlated the neurologic observations, and the latter admirably described the roentgenographic changes in patients with the anomaly. The condition is generally accepted as representing, basically, a developmental anomaly of the craniovertebral boundary, the most striking feature being an invagination of the basiocciput by an upward projection of elements of the atlas and axis. When they are viewed from inside the cranial cavity, the foramen magnum is stenosed and the clivus forms a convex band,

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