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Basilar invagination (upward bulging of the occipital condyles)

Basilar invagination, also called basilar impression, is a relatively rare congenital or acquired craniocervical junction abnormality characterized by upward and posterior migration of the second cervical vertebra into the intracranial space.

Causes of Basilar invagination

Basilar invagination can be congenital i.e. present on birth. Otherwise it may be acquired in lifetime due to following reasons:

  • Injury by
    • Vehicle or bicycle accidents
    • Falls   
    • Recreational activities such as diving accidents  
  • Bone diseases like  
    • Rheumatoid arthritis
    • Paget's disease
    • Tumor
    • Osteomalacia/rickets    

Symptoms of Basilar invagination

Stenosis of the foramen magnum and compression of the medulla oblongata result in following neurological symptoms:

  • Headache especially in the back of head
  • Dizziness
  • Swallowing problems
  • Numbness/tingling in the extremities
  • Paralysis
  • Worsening of symptoms with flexion of the head
  • Periods of confusion or consciousness
  • Loss of sensation
  • Death

Diagnosis of Basilar invagination:  

Diagnosis depends upon the symptoms, physical and neurological examination of the patient  along with following tests:

  • An X-ray
  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT) scan

Treatment of Basilar invagination:  

Treatment depends upon severity of the condition and symptoms of the patient. It may include:

  • Non-operative modalities or conservative approach is followed for patients with no neurological symptoms. It may include
    • Physical therapy
    • Non-steroidal anti-inflammatory medication
    • Cervical collar
    • Neck traction  
  • Surgery is done in patients with severe spinal cord compression or neurological deficit and usually involves the removal of bone that is causing the compression and stabilization using spinal instrumentation.

Authored by Dr. Shyam Sundar K

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Dr. Shyam Sundar K

Dr. Shyam Sundar K is an eminent name in the field of neurology. He is one of the best neurosurgeon in Chennai, Tamil Nadu

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