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Related Concept Videos

Cranial and Spinal Meninges01:19

Cranial and Spinal Meninges

The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
Articulations of the Vertebral Column01:28

Articulations of the Vertebral Column

In addition to being held together by the intervertebral discs, adjacent vertebrae also articulate with each other at synovial joints formed between the superior and inferior articular processes called zygapophysial joints (facet joints). These are plane joints that provide for only limited motions between the vertebrae. The orientation of the articular processes at these joints varies in different regions of the vertebral column and serves to determine the types of motions available in each...
Cranial Bones: Superior and Posterior View01:14

Cranial Bones: Superior and Posterior View

The superior view of the cranium shows the frontal and paired parietal bones.
The frontal bone is the single bone that forms the forehead. At its anterior midline, between the eyebrows, there is a slight depression called the glabella. The frontal bone also forms the supraorbital margin of the orbit. Near the middle of this margin is the supraorbital foramen, the opening that provides passage for a sensory nerve to the forehead. The frontal bone is thickened just above each supraorbital margin,...
Veins of Head and Neck01:19

Veins of Head and Neck

The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
Arteries of the Head and Neck01:26

Arteries of the Head and Neck

The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
Cranial Bones: Lateral View01:27

Cranial Bones: Lateral View

The lateral view of the cranium is dominated by temporal, sphenoid, and ethmoid bones.
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...

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Modeling Brain Metastasis by Internal Carotid Artery Injection of Cancer Cells
10:01

Modeling Brain Metastasis by Internal Carotid Artery Injection of Cancer Cells

Published on: August 2, 2022

Metastases to the craniovertebral junction.

Hugh D Moulding1, Mark H Bilsky

  • 1Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.

Neurosurgery
|February 23, 2010
PubMed
Summary

Craniovertebral junction (CVJ) metastases are rare spinal tumors. Effective management with radiation and surgery improves pain and function in selected patients.

Area of Science:

  • Neurosurgery
  • Oncology
  • Radiology

Background:

  • Craniovertebral junction (CVJ) metastases are rare, accounting for less than 1% of spinal metastases.
  • These tumors present diagnostic and treatment challenges due to their location and rarity.

Purpose of the Study:

  • To review the literature on the management of craniovertebral junction (CVJ) metastases.
  • To define the epidemiology, imaging, and treatment protocols for metastatic CVJ tumors.

Main Methods:

  • A comprehensive PubMed search was conducted using keywords related to cervical spine metastases and CVJ tumors.
  • Literature review focused on epidemiology, imaging modalities, and treatment strategies.

Main Results:

  • CVJ tumors cause flexion, extension, and rotational pain, often with occipital neuralgia.

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  • MRI is the most sensitive imaging modality; CT and PET scans also aid diagnosis.
  • Radiation therapy (conventional or stereotactic) and surgery are effective treatments.
  • Surgical indications include significant subluxations (>5 mm or 3.5 mm with 11-degree angulation).
  • Posterior surgical approaches (laminectomy, occipitocervical instrumentation) are preferred for decompression and stabilization.

    • Conclusions:

    • Effective management of CVJ tumors with radiation and/or surgery significantly improves pain and function.
    • Advanced surgical techniques and stereotactic radiation offer potential for improved outcomes with reduced morbidity.