The malformation is comparable to the Chiari type I malformation described in people and includes a congenital malformation
of the occipital bone, resulting in a crowded caudal fossa and cerebellar herniation at the foramen magnum.
When performing FMD, both portions
of the occipital bone and the lamina of the C1 vertebral body are removed to provide bony decompression (Fig 19).
This can be done by either removing some or
all of the occipital bone.
This is accomplished by removing the back
of the occipital bone and often the top of the first few vertebrae.
References Rusbridge C and Knowler SP, 2003 Hereditary aspects
of occipital bone hypoplasia and syringomyelia (Chiari type I malformation) in cavalier King Charles spaniels.
Veterinary Record 153: 107 - 112 Rusbridge C and Knowler SP, 2004 Inheritance
of Occipital Bone Hypoplasia (Chiari type I malformation) in Cavalier King Charles spaniels.
The term craniovertebral junction refers to the bony structures surrounding the medulla oblongata, the cervicomedullary junction and the upper cervical spinal cord and is constructed
of the occipital bones forming the foramen magnum, the atlas and the axis.
Not exact matches
The term refers to the fact that the back
of your baby's skull (the
occipital bone) is in the back (or posterior)
of your pelvis.
According to most definitions, the trapezius muscles are large, diamond - shaped surface muscles that extend longitudinally from the
occipital bone to the lower thoracic vertebrae and laterally to the spine
of the scapula.
In human anatomy, the trapezius is either one
of two large superficial muscles that extend longitudinally from the
occipital bone to the lower thoracic vertebrae and laterally to the spine
of the scapula (shoulder blade).
The most common procedure for Chiari like malformation is suboccipital decompression where the hypoplastic
occipital bone and sometimes the cranial dorsal laminae
of the atlas are removed (with or without a durotomy) to decompress the foramen magnum.
A black line (A) extends from the tip
of the nasal
bone to the
occipital protuberance.
CMs may develop when the bony space, caudal
occipital bone, is smaller than normal, causing the cerebellum and brain stem to be pushed downward into the foramen to the level
of the foramen magnum (mild CM) or through the foramen magnum (severe CM) into the upper spinal canal.
We can describe Chiari - like Malformation as an overcrowded and narrow caudal
occipital fossa and cervicomedullar junction due to a congenital developmental malformation
of caudal
occipital bone.
We can describe magnetic resonans imaging findings as a narrow subarachnoid space in cervicomedullar junction,
occipital bone compression on caudal cerebellum, rostral movement
of caudal cerebellum, syringomyelia, cerebellar herniation from foramen magnum and kinked appearance
of caudal medulla.
In performing a cranioplasty, guide holes for titanium screws are made in the
occipital bone, around the edge
of the FMD defect.
The Red bars represent the division
of the CCF into a caudal part and a rostral part by a plane orthogonal to the sagittal images, intersecting the base
of the internal
occipital protuberance and orientated perpendicular to the basioccipital
bone.
If this is also true in dogs it may have implications for the development
of CM, as the CCF may have a restricted capacity to adapt to the volume
of an enlarged cerebellum through expansion
of the sutures between the
occipital bones and their neighbours.
The authors suggested that, in this breed,
occipital bone development is insensitive to changes in hindbrain volume and that there is a compensatory bulging
of the tentorium cerebelli in a rostral direction [39].
Occipital dysplasia (i.e. widened foramen magnum) also may be seen [29]; however this is probably an acquired condition due to overcrowding
of the caudal cranial fossa, mechanical pressure from the cerebellum and supraoccipital
bone resorption [30].
The CCF was divided into a caudal part and a rostral part by a plane orthogonal to the sagittal images, intersecting the base
of the internal
occipital protuberance and orientated perpendicular to the basioccipital
bone (see Figure 2).
Angle 2 could also be more acute if the atlas were closer to the occiput either because the supraoccipital
bone had lost is convexity i.e. was less rounded or in the event
of atlanto -
occipital overlapping / proximity.
In one study, the
occipital bones showed a resorbtive pattern
of bone around the cerebellar hemispheres in adults and in children [44], suggesting that
bone remodelling continues long after skull sutures have fused.