The C2-C3 cervical intervertebral disc, the
atlantooccipital joint, and the C3-C4 facet joint also can cause CH (9,10).
Others have theorized that Chiari-1 malformation, cervical spina bifida occulta, cervical scoliosis, Klippel-Feil deformity, atlantoaxial assimilation,
atlantooccipital fusion, and basilar invagination maybe developmental variants along a spectrum of severity common to the base of the skull and upper cervical spine [6].
After reduction, computed tomography was performed and we confirmed the complete reduction of both the
atlantooccipital joint and the atlantoaxial joint (Figure 2).
Cervical spine malformations and craniovertebral junction abnormalities which lead to hypermobility of
atlantooccipital joints, give rise to neurological and vascular symptoms.
The cranial base's cartilages are known to resist compression [27] and the
atlantooccipital joint is primarily under static strain [28].
The beam of the C-arm was oriented to expose the
atlantooccipital and axial joints.
Thereby, either anterior or posterior longitudinal ligaments were left intact as well as the joint capsules C0/C1 and C1/2 and the atlantoaxial and
atlantooccipital ligaments.
However, pediatric anesthetists and intensivists are concerned about optimal glottic visulaization and try to facilitate intubation by using some techniques such as head positioning.8 The age of children is the most important factor of head posture.9 The sniffing position can be ensured by placing a pillow under the occiput of the patient and results in
atlantooccipital extension and cervical flexion.10
Next, the liquor sample (50-80[micro]L) was collected in
atlantooccipital space.
Al realizarle una resonancia magnetica de imagen y de angiografia, se determinaron arterias vertebrales tortuosas y compresion del surco preolivar secundario a una estenosis del canal hipogloso, debido a una malformacion de la articulacion
atlantooccipital.
