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Os odontoideum with cerebellar infarction: a case report
1Department of Orthopedic Surgery, Yamagata University School of Medicine, Yamagata City, Japan. hasasaki@med.id.yamagata-u.ac.jp
Spine
|May 2, 2000
Summary
Atlantoaxial instability with os odontoideum can cause vertebrobasilar artery insufficiency, leading to cerebellar infarction in children. Surgical stabilization effectively resolved the patient's symptoms and prevented recurrence.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Radiology
Background:
- Vertebrobasilar artery insufficiency (VBAI) linked to atlantoaxial instability (AAI) is not well-understood.
- Os odontoideum is a rare congenital anomaly causing AAI.
Observation:
- A 5-year-old boy presented with ataxic gait and was diagnosed with cerebellar infarctions.
- Imaging revealed AAI with os odontoideum, basilar artery branch occlusions, and a tortuous vertebral artery.
Findings:
- Posterior C1-C2 screw fixation with iliac bone graft achieved stable fusion of the atlantoaxial joint.
- The patient experienced resolution of VBAI symptoms and cerebellar dysfunction post-surgery.
Implications:
- AAI, particularly with os odontoideum, is a potential cause of VBAI and subsequent neurological deficits.
- Early recognition and surgical intervention for AAI are crucial for preventing severe neurological complications.