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Radiological evolution of peri-odontoid pannus in a patient with Chiari I malformation: a case-based review

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Abstract

Introduction

The Chiari I malformation (CIM) is commonly encountered by neurosurgeons and can have different etiologies and clinical presentations.

Case report

We report a CIM patient who presented with symptoms of ventral brain stem compression and was found to have a large peri-odontoid pannus. Posterior fossa decompression was performed with a planned second-stage odontoidectomy. However, at the 6-month follow-up, postoperative images demonstrated a mostly resolved pannus and improvement of the brain stem compression symptoms, and the patient progressed uneventfully without the need for odontoidectomy.

Conclusions

This case illustrates the resolution of a significant and symptomatic peri-odontoid pannus in a patient with CIM without craniocervical fusion or odontoidectomy. Such a case indicates that not all peri-odontoid pannus formations in CIM patients are due to hypermobility at the craniocervical junction.

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References

  1. Cesmebasi A, Loukas M, Hogan E, Kralovic S, Tubbs RS, Cohen-Gadol AA (2015) The Chiari malformations: a review with emphasis on anatomical traits. Clin Anat 28:184–194

    Article  PubMed  Google Scholar 

  2. Tubbs RS (2015) Definitions and anatomic considerations in Chiari I malformation and associated syringomyelia. Neurosurg Clin North Am 26:487–493

    Article  Google Scholar 

  3. Rajak R, Wardle P, Rhys-Dillon C, Martin JC (2012) Odontoid pannus formation in a patient with ankylosing spondylitis causing atlanto-axial instability. BMJ Case Reports 2012

  4. Salli A, Sahin N, Paksoy Y, Kucuksarac S, Ugurlu H (2009) Treatment of periodontoid pannus with infliximab in a patient with rheumatoid arthritis. J Clin Rheumatol 15:250–251

    Article  PubMed  Google Scholar 

  5. Tubbs RS, Griessenauer CJ, Hendrix P, Oakes P, Loukas M, Chern JJ, Rozzelle CJ, Oakes WJ (2015) Relationship between pharyngitis and peri-odontoid pannus: a new etiology for some Chiari I malformations? Clin Anat 28:602–607

    Article  PubMed  Google Scholar 

  6. Lagares A, Arrese I, Pascual B, Gomez PA, Ramos A, Lobato RD (2006) Pannus resolution after occipitocervical fusion in a non-rheumatoid atlanto-axial instability. Eur Spine J 15:366–369

    Article  PubMed  Google Scholar 

  7. Liu JK, Patel J, Goldstein IM, Eloy JA (2015) Endoscopic endonasal transclival transodontoid approach for ventral decompression of the craniovertebral junction: operative technique and nuances. Neurosurg Focus 38:E17

    Article  PubMed  Google Scholar 

  8. Zygmunt S, Saveland H, Brattstrom H, Ljunggren B, Larsson EM, Wollheim F (1988) Reduction of rheumatoid periodontoid pannus following posterior occipito-cervical fusion visualised by magnetic resonance imaging. Brit J Neurosurg 2:315–320

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Neurosurgery Division, Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Felipe Hada Sanders

  2. Department of Anatomical Sciences, St. George’s University, St. George’s, West Indies, Grenada

    Joy M. H. Wang

  3. Seattle Science Foundation, Seattle, WA, USA

    Rod J. Oskouian & R. Shane Tubbs

  4. Children’s of Alabama, Birmingham, AL, USA

    W. Jerry Oakes

Authors
  1. Felipe Hada Sanders
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  2. Joy M. H. Wang
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  3. Rod J. Oskouian
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  4. R. Shane Tubbs
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  5. W. Jerry Oakes
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Corresponding author

Correspondence to Joy M. H. Wang.

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Sanders, F.H., Wang, J.M.H., Oskouian, R.J. et al. Radiological evolution of peri-odontoid pannus in a patient with Chiari I malformation: a case-based review. Childs Nerv Syst 33, 1415–1417 (2017). https://doi.org/10.1007/s00381-017-3459-1

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  • DOI: https://doi.org/10.1007/s00381-017-3459-1

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