The Role of MDCT in Craniocervical Junction Pathologies: Pictorial Review

Abstract

Introduction: Craniocervical junction pathologies are seldom pathologies having a vital importance because of their location. Thats why preoperative correct evaluation and detection of relation with adjacent tissue of this area pathologies is important for proper treatment plan. Multidetector computed tomography (MDCT) imaging is an improving and being a widely used method recently in many areas of medicine. It is possible to evaluate the peripheric vascular structures, anatomic variations or vascular pathologies with MDCT angiography (MDCTA). Methods: The arcuate foramen is an anatomical variant of the atlas vertebra: anterior and posterior osseous bridges or ponticles can arch over the vertebral artery, to a greater or lesser degree, transforming the arterial groove into a canal. Dissection of the vertebral artery leading to thrombotic occlusion or ischaemia from narrowing of the arterial lumen has been described in trauma. There are fistula between a dural branch of the spinal ramus of a radicular artery and an intradural medullary vein in spinal vascular malformations. MDCT angiography is feasible and is an alternative technique in diagnosis spinal vascular malformations. The craniovertebral junction (CVJ) is a funnel-shaped structure comprised of the clivus and foramen magnum and the upper two cervical vertebrae. The most frequent neoplastic lesions of the craniovertebral junction are meningiomas, neurinomas, chordomas, paragangliomas, epidermoids, dermoids and chondrosarcomas. Conclusion: In this presentation, pathologies seen in craniocervical junction (congenital variation, trauma, vascular malformation and tumor) were discussed with figures and compared with the literature. Keywords: Vertebral artery, MDCT, craniocervical junction