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ARCUATE FORAMEN OF ATLAS: DO I NEED TO DIAGNOSE?

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Yanova Elvira Umarjonovna 1 *, Mardieva Gulshod Mamatmuradovna1

Abstract

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 mmon 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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