Congenital irreducible atlantoaxial dislocation associated with cervical intramedullary astrocytoma causing progressive spastic quadriparesis.

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dc.contributor.authorChatley, Anoojen_US
dc.contributor.authorJaiswal, Awadesh Ken_US
dc.contributor.authorJain, Manojen_US
dc.contributor.authorBehari, Sanjayen_US
dc.date.accessioned2008-10-08en_US
dc.date.accessioned2009-06-03T10:53:25Z
dc.date.available2008-10-08en_US
dc.date.available2009-06-03T10:53:25Z
dc.date.issued2008-10-08en_US
dc.description.abstractSimultaneous presence of congenital irreducible atlantoaxial dislocation (AAD) and cervical intramedullary astrocytoma has not been previously described and may cause disabling myelopathy. This 55-year-old lady presented with suboccipital pain, spastic quadriparesis, Lhermitte's phenomenon and sphincteric disturbances. Lateral radiographs and magnetic resonance imaging showed irreducible AAD, occipitalized atlas, C2-3 fusion, and,an intramedullary tumor from C2-5 level iso-to-hypointense, non-enhancing, except in a small segment in the dorsal C2 level. A suboccipital craniectomy with C2-5 laminectomy revealed a greyish-white tenacious tumor. The tumor was decompressed using a C2-5 midline myelotomy and duroplasty. An occipitocervical lateral mass fixation was performed. Histopathology revealed a low-grade astrocytoma. At three-month follow-up, her spasticity had decreased and quadriparesis and sphincteric disturbances were persisting. Postoperative lateral radiographs and intrathecal contrast CT scan showed a stable occipitocervical construct. Thus, the suboccipital craniectomy and laminectomy with midline myelotomy and duroplasty facilitated space for progressively expanding intramedullary astrocytoma with irreducible AAD; the lateral mass fixation provided stability at the craniovertebral junction.en_US
dc.description.affiliationDepartment of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.en_US
dc.identifier.citationChatley A, Jaiswal AK, Jain M, Behari S. Congenital irreducible atlantoaxial dislocation associated with cervical intramedullary astrocytoma causing progressive spastic quadriparesis. Neurology India. 2008 Oct-Dec; 56(4): 477-9en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/120522
dc.language.isoengen_US
dc.source.urihttps://neurologyindia.comen_US
dc.subject.meshAstrocytoma --complicationsen_US
dc.subject.meshAtlanto-Axial Jointen_US
dc.subject.meshDislocations --complicationsen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMagnetic Resonance Imagingen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNeurosurgical Proceduresen_US
dc.subject.meshQuadriplegia --etiologyen_US
dc.subject.meshSpinal Neoplasms --complicationsen_US
dc.titleCongenital irreducible atlantoaxial dislocation associated with cervical intramedullary astrocytoma causing progressive spastic quadriparesis.en_US
dc.typeCase Reportsen_US
dc.typeJournal Articleen_US
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