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State of the Art Cranial Ultrasound Imaging in Neonates

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Published on: February 2, 2015

A rare case of basilar impression.

Rajesh Verma¹, Vivek Junewar, Ravindra Kumar Garg

¹Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India. drrajeshverma32@yahoo.com

BMJ Case Reports

|June 7, 2012

Summary

Craniovertebral junction Pott's disease, a rare spinal tuberculosis form, caused severe neck pain and quadriparesis in a teenage girl. Prompt diagnosis and antitubercular treatment led to significant neurological recovery.

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Area of Science:

Neurology
Infectious Diseases
Spinal Surgery

Background:

Pott's disease, a form of tuberculosis affecting the spine, can present with diverse neurological complications.
Craniovertebral junction involvement is particularly rare and challenging to diagnose.
Early recognition is crucial for preventing irreversible neurological damage.

Observation:

A teenage female presented with progressive neck pain, fever, anorexia, weight loss, and subsequent quadriparesis.
Cervical spine MRI revealed extensive prevertebral and paravertebral abscesses, atlantoaxial dislocation, and basilar invagination.
The dislocated dens compressed the cervicomedullary junction, indicating severe craniovertebral junction compromise.

Findings:

Diagnosis of craniovertebral junction Pott's disease was established based on clinical and radiological findings.
The patient received conservative management including neck immobilization with a cervical collar.
Antitubercular therapy was initiated as the primary treatment modality.

Implications:

This case highlights the importance of considering spinal tuberculosis in the differential diagnosis of neck pain and progressive neurological deficits.
Conservative management with antitubercular drugs can be effective in treating craniovertebral junction Pott's disease.
Successful treatment resulted in significant improvement of neurological deficits, underscoring the treatable nature of this condition with timely intervention.