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Cervical Myelopathy at Craniovertebral Junction Secondary to Compression by Posterior Atlanto-occipital Membrane: A Case Report |
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Venu Madhav Pinninti, Ramakrishna Narayanan 1. Junior Resident, Department of Radiodiagnosis, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India. 2. Additional Professor, Department of Radiodiagnosis, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India. |
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Correspondence Address : Venu Madhav Pinninti, Plot No 93, Road No. 16, Snehapuri Colony, Hyderabad-500076, Telangana, India. E-mail: venumadhav94922@gmail.com |
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| ABSTRACT |  | ||||||
: The Craniovertebral Junction (CVJ) comprises of the skull base (occipital bone), upper cervical spine (atlas and axis) and surrounding neurovascular structures, including the brainstem, spinal cord and vertebral arteries. Its stability depends on strong ligaments, membranes and bony anatomy, allowing key movements like rotation and flexion-extension. Cervical myelopathy significantly affects quality of life and can be caused by both common and rare causes. Common causes include degenerative disc disease, cervical spondylosis, spinal stenosis, herniated discs and trauma, all of which lead to compression of the spinal cord due to wear, injury, or misalignment in the cervical spine. Less common causes involve congenital abnormalities in the spinal structure, tumours, infections, rheumatoid arthritis, atlanto-occipital membrane issues and Chiari malformation, all of which lead to spinal cord compression. Despite a thorough diagnostic evaluation, around 20% of cases remain idiopathic. The authors hereby, present a case of a 59-year-old male with suboccipital and neck pain radiating predominantly to the left upper and lower limbs, accompanied by paraesthesias. Imaging revealed a congenital anomaly of the atlas, characterised by the absence of the left half of the posterior arch (Currarino type B). This structural defect led to stretching and ventral displacement of the Posterior Atlanto-occipital Membrane (PAOM), resulting in compression and myelomalacia of left hemispinal cord. | |||||||
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| Keywords : Craniovertebral junction anomalies, Currarino congenital anomalies of atlas, Currarino type B | |||||||
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DOI and Others :
DOI: 10.7860/IJARS/2026/84751.3097
Date of Submission: Oct 07, 2025 Date of Peer Review: Jan 13, 2026 Date of Acceptance: Feb 10, 2026 Date of Publishing: May 01, 2026 AUTHOR DECLARATION: • Financial or Other Competing Interests: None • Was informed consent obtained from the subjects involved in the study? Yes • For any images presented appropriate consent has been obtained from the subjects. Yes PLAGIARISM CHECKING METHODS: • Plagiarism X-checker: Nov 06, 2025 • Manual Googling: Feb 07, 2026 • iThenticate Software: Feb 09, 2026 (1%) ETYMOLOGY: Author Origin EMENDATIONS: 6 |
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Case report
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