CT scan revealed partial aplasia of the anterior and posterior arches of the C1 vertebra, resulting in a split atlas with a platybasia and basilar impression (shown in Fig. Plain radiographs were interpreted as normal, and dynamic radiological assessment did not show any instability. Furthermore, examination of the perineal area was unremarkable. In the right upper extremity, motor function was rated 3–4 out of 5, with hypoesthesia in the C7–C8 territory. Motor function and sensory examination were normal in the left upper limb and lower limbs. Neurological assessment revealed pyramidal syndrome with bilateral upper and lower limbs hyperreflexia, bilateral Babinski sign, and Hoffman’s reflex present. His symptomatology was improving gradually, but there was no bowel or bladder dysfunction.Īt the time of admission, physical examination revealed a walk with mowing on the right side, pain on palpation of the upper cervical spine, contracture of the paravertebral muscles, and limited cervical range of motion. We report the case of a rare “benign” congenital malformation of the OCJ associated with neurological disorders.Ī previously healthy, 18-year-old male patient presented with a 6-month history of paresthesia of both arms and legs, cervical pain, and walking difficulty after a minor neck trauma (he fell from his height and landed on the occiput, with hyperflexion of the cervical spine). This highly polymorphism may be responsible for serious neurological disorders. These malformations are diverse, often associated with each other. Many types of bone and/or nerve malformations, major or minor, have been described but remain rare. The occipitocervical junction (OCJ) is a complex anatomical area that includes several vital structures and allows mechanical transition between the central nervous system and the axial skeleton.
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