Evaluation of congenital anomalies of craniovertebral junction by computed tomography and its embryological basis

Abstract

Introduction: Craniovertebral junction (CVJ) is the most complex part of the cervical region. Congenital malformations of this region can cause serious neurological deficit and require a surgical intervention. The present study was undertaken to know the embryological basis of the CVJ and to identify commonly observed congenital CVJ abnormalities, their frequency and mode of presentation. Materials and Methods: Diagnosed cases of CVJ anomalies on computed tomography (CT) head were reviewed. Type of anomaly, clinical presentation, other associated malformations were recorded. Different types of variations were expressed in terms of percentage. Result: Congenital anomalies were seen in 26 cases. Fifteen types of anomalies were detected. Anomalies were either singly or in combination. Most common anomaly was basilar invagination (23.8%) followed by atlanto-occipital assimilation (19%). In seven cases additional anomalies of other vertebrae were present. Maximum eight cases were detected in age group of 11-20 years. There was male predominance. Commonest symptoms were weakness of extremities, neck pain, paresthesia, torticollis and gait disturbances. Conclusion: Congenital CVJ anomalies are rare. To prevent long-term neurological problems, early diagnosis and treatment of congenital bony CVJ anomalies is important. Keywords: Craniovertebral junction, Congenital, Anomaly.