RT Journal
A1 Kukkar, Nitin
A1 Amin, Devin V.
A1 Beck, Ryan T.
A1 Bedi, Neru
A1 Freitag, Per
T1 Cervicomedullary Compression at the Craniovertebral Junction by Clivus HyperplasiaA Case Report
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2011
FD October 19
VO 93
IS 20
SP e119 1
OP 5
DO 10.2106/JBJS.J.01444
UL http://dx.doi.org/10.2106/JBJS.J.01444
AB 
The craniovertebral junction (CVJ), which is composed of the distal third of the clivus, the occiput, the atlas, the axis, and the foramen magnum, is complex anatomically and includes important neurovascular structures1,2. Together, these structures enclose the cervicomedullary junction (CMJ) and the lower four cranial nerves. Signs and symptoms of abnormal conditions affecting the CVJ are varied and typically begin insidiously. They may be referable to the brainstem, cervical cord, cerebellum, cervical nerve roots, or lower cranial nerves or the vascular supply to these structures. Anterior compression at the CVJ can occur in many types of abnormalities: malformations (basilar invagination or cranial settling, atlas assimilation, os odontoideum, and atlantoaxial fixed dislocation), tumor, trauma, chronic inflammatory diseases (most frequently, rheumatoid arthritis [RA]), and osteomyelitis3-7. Not uncommonly, congenital ventral compression of the CVJ is discovered on postmortem examination8.