ARCUATE FORAMEN OF ATLAS: DO I NEED TO DIAGNOSE?
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 2, Pages 2989-2997
AbstractIt 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
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.
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