Platybasia and Klippel Feil-syndrome: case report

A case is presented of a 35-year-old woman diagnosed with platybasia associated with Klippel-Feil syndrome type I. She was admitted to University Department of Neurology for clinical examination because of walking difficulties, dizziness, and intermittent vision disturbances. Neurological examination revealed a predominance of cerebellar symptomatology. Relevant diagnostic work-up included craniogram, cervical spine x-ray, computed tomography (CT) of the brain and craniocervical junction, magnetic resonance imaging of the brain, electroencephalography, ophthalmologic examination, urinary tract ultrasonography, laboratory tests, and psychological testing. CT of the craniocervical junction showed platybasia, congenital fusion of the second and third cervical vertebrae, and basilar invagination of dens axis. Platybasia is leveling of the angle between the floor of the anterior cranial fossa and posterior cranial fossa in the area of sella turcica, which is normally at 115-140 degrees. Basilar impression or invagination is moving up of the basis of the occiput and occipital condyles into the cranium, which means that the borders of the foramen magnum, condyles and adjacent bone are invaginated into the posterior fossa. Klippel-Feil syndrome type II is massive fusion of two of seven cervical vertebrae associated with short neck and low hair line.