Online ISSN: 2515-8260

Keywords : atlas


ARCUATE FORAMEN OF ATLAS: DO I NEED TO DIAGNOSE?

Yanova Elvira Umarjonovna; Mardieva Gulshod Mamatmuradovna

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 2989-2997

It was found that the joint presence of bone and vascular changes in the
craniovertebral region, or even one of them, can lead to a clinically significant
decrease in cerebral blood flow. One of the fairly common anomalies is the arcuate
foramen, which does not have a characteristic clinic and is disguised as other
pathologies.
Purpose.To analyze the computed tomographic characteristics of the bone
jumper of the first cervical vertebra.
Materials and methods. A retrospective analysis of computed tomographic
examinations of the upper cervical spine in 479 patients using 3-dimensional (3D)
reconstruction was carried out. The patients' age ranged from 12 to 85 years. In 61 
patients, Kimmerle anomaly was diagnosed. The average age of men was 39.7 ± 6.3
years, women - 44.8 ± 6.7 years.
Results.When conducting a computed tomography of the brain of patients with
Kimmerle's anomaly, in 25 cases out of 42 - signs of vascular encephalopathy, in 11
cases signs of cerebellar atrophy and in 5 cases - single cysts. In 84% of patients with
Kimmerle's anomaly, who underwent 3D CT of the cervical spine, osteochondrosis
was noted and in 21% - spondylosis, in 74% of cases combined with degenerative
changes in the intervertebral disc. In 70% of patients with Kimmerle's anomaly, there
is a bilateral arrangement of the atlas bone jumper. With a one-sided arrangement, the
atlas bone jumper is often located on the left. The vaulted hole was located on both
sides equally often. The anteroposterior dimension of the arcuate foramen on the right
is 5.4 ± 2.32 mm, on the left - 5.9 ± 2.43 mm. Vertical dimension - 3.35 ± 1.83 mm
on the right, 3.49 ± 1.87 mm on the left. The incidence of the anomaly was 12.7%.
Conclusions.A spondylogenic factor, in the form of Kimmerle's anomaly, can
cause impaired craniovertebral circulation, given the combination with ischemic
changes in the computed tomographic picture of the posterior parts of the brain.
Additional research is needed to assess the state of the vascular bed and blood flow in
the vessels, which will provide the prevention and treatment of cerebrovascular
disorders in patients with Kimmerle's anomaly.

Ossification of the transverse atlantal ligament forming prominent osteophytes

Zygmunt Siedlecki; Maciej Śniegocki; Mariusz Baumgart; Michał Szpinda

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 1021-1026

The ossifications of the transverse atlantal ligament taking the form of prominent osteophytes within atlas occur rarely.A computed tomographyexamination of the head in a 57-year-old man revealedthesignificantossifications ofthe transverse atlantal ligamentattachments. In the present study, the Osirix 3.9 MD system was employed to perform the bilateral evaluation of linear dimensions, projection surface area and volume of the theseossifications-osteophytes. The sagittal and transverse diameters of examined ossifications were: on the right side 4.02 and 3.97 mm, respectively, and on the left side 3.62 and 3.14 mm, respectively. Furthermore, on the right side the projection surface area and volume were: 12.03 mm2 and 27.66 mm3, respectively, and on the left side – 9.78 mm2 and 23.57 mm3, respectively.Ossified attachments of the transverse ligament forming osteophytesseem to be casuistic.