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Radiological evolution of peri-odontoid pannus in a patient with Chiari I malformation: a case-based review
Felipe Hada Sanders1, Joy M H Wang2, Rod J Oskouian3
1Neurosurgery Division, Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Introduction:
The Chiari I malformation (CIM) is commonly encountered by neurosurgeons and can have different etiologies and clinical presentations.
Case Report:
We report a CIM patient who presented with symptoms of ventral brain stem compression and was found to have a large peri-odontoid pannus. Posterior fossa decompression was performed with a planned second-stage odontoidectomy. However, at the 6-month follow-up, postoperative images demonstrated a mostly resolved pannus and improvement of the brain stem compression symptoms, and the patient progressed uneventfully without the need for odontoidectomy.
Conclusions:
This case illustrates the resolution of a significant and symptomatic peri-odontoid pannus in a patient with CIM without craniocervical fusion or odontoidectomy. Such a case indicates that not all peri-odontoid pannus formations in CIM patients are due to hypermobility at the craniocervical junction.
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