Isolated atlas-duplication as a manifestation of persistent proatlas: a case report.
Atlas-duplication
Congenital spine
Craniocervical junction
Proatlas
Journal
Surgical and radiologic anatomy : SRA
ISSN: 1279-8517
Titre abrégé: Surg Radiol Anat
Pays: Germany
ID NLM: 8608029
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
23
01
2022
accepted:
24
02
2022
pubmed:
15
3
2022
medline:
31
3
2022
entrez:
14
3
2022
Statut:
ppublish
Résumé
Atlas-duplication is an exceedingly rare dysplasia of the craniocervical junction. To the best of our knowledge, only two cases of atlas-duplication have been reported and these were associated with complete anterior rachischisis and os odontoideum. We aimed to report a case of isolated atlas-duplication of incidental finding and without attributable symptoms which makes it unique. Following a normal coronarography for a suspected myocardial infarction, a 60-year-old-man with no significant medical history developed a transient ischemic attack that justified brain computed-tomography angiography. There was no evidence for cerebral ischemic lesion, intracranial occlusion or significant artery disease. Bone analysis revealed eight cervical vertebral segments with an additional vertebral level located between the occiput and the atlas. This vertebra presented all the morphological characteristics of an atlas vertebra except for hypoplasia of the left transverse process. An incomplete anterior rachischisis was associated, and there was no other abnormality of craniocervical junction. The clinical examination revealed no neck pain, no limitation of joint amplitude and no neurological deficit. Apart from preventive treatment of ischemic stroke, no orthopedic or surgical treatment was undertaken. After 1.5 years of radiological monitoring, the patient remains symptom-free. Atlas-duplication is an exceedingly rare dysplasia of the craniocervical junction that may be found isolated and incidentally. If this variation does not necessarily warrant specific treatment, brain CT angiography is recommended to detect anatomical variations of the vertebral arteries.
Identifiants
pubmed: 35284975
doi: 10.1007/s00276-022-02918-7
pii: 10.1007/s00276-022-02918-7
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
595-598Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
Références
Kessel M, Balling R, Gruss P (1990) Variations of cervical vertebrate after expression of Hox-1.1 transgene in mice. Cell 61:301–308
doi: 10.1016/0092-8674(90)90810-2
Klimo P, Coon V, Brockmeyer D (2011). Incidental os odontoideum: current management and strategies. FOC 31-E10
Menezes AH (2008) Craniocervical developmental anatomy and its implications. Childs Nerv Syst 24:1109–1122
doi: 10.1007/s00381-008-0600-1
Le Double AF (192). Traité des variations de la colonne vertébrale de l’Homme et leur signification au point de vue de l’anthropologie zoologique. Paris : Vigot frères.
Offiah CE, Day E (2017) The craniocervical junction: embryology, anatomy, biomechanics and imaging in blunt trauma. Insights Imaging 8:29–47
doi: 10.1007/s13244-016-0530-5
Pang D, Thompson DNP (2011) Embryology and bony malformations of the craniovertebral junction. Childs Nerv Syst 27:525–564
Shapiro R, Robinson F (1976). Anomalies of craniovertebral border. American Journal of Roentgenelogy.
Shoja MM, Rhamdhan R, Jeansen CJ et al (2018) Embyology of the craniovertebral junction and posterior fossa, part I: developpement of the upper vertebrae and skull. Clin Anat 31:466–487
doi: 10.1002/ca.23049
Spittank H, Goehmann U, Hage H, Sacher R (2016) Persistent proatlas with additional segmentation of the craniovertebral junction—The Tsuang-Goehmann Malformation. Radiology Case 10:15–23
doi: 10.3941/jrcr.v10i10.2890
Tsuang F-Y, Chen J-Y, Wang Y-H, Lai D-M (2011) Occipitocervical malformations with atlas duplication. J Neurol Neurosurg Psychiatry 82:1101–1102
doi: 10.1136/jnnp-2011-300200