Pseudotumor of the craniovertebral junction associated with chronic subluxation: MR imaging studies

Masses at the craniovertebral junction generally have serious prognostic implications. However, the authors studied three patients who had chronic atlantoaxial subluxation from either degenerative disease or congenital dysplasia of the dens and who also had benign fibrous masses in this region, confirmed at surgery. The association of masses of the craniovertebral junction with chronic atlantoaxial subluxation raises the possibility that the underlying cause of the masses is chronic mechanical irritation. All patients were imaged with metrizamide myelography and adjunctive computed tomography (CT), then by magnetic resonance (MR) imaging. MR images were not only superior to myelograms and CT scans in delineating the exact extent of the lesions, they also indicated the benign, fibrous nature of the masses.