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Anat Cell Biol

Published online November 16, 2020

https://doi.org/10.5115/acb.20.264

Copyright © Korean Association of ANATOMISTS.

Chiari 1.5 malformation, accessory odontoid synchondrosis, and ventral compression: case report

Dany Hage1 , Joe Iwanaga1,2 , CJ Bui4 , Aaron S. Dumont1 , R. Shane Tubbs1,2,3,4,5

1Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, 2Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, 3Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, 4Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA, 5Department of Anatomical Sciences, St. George’s University, St. George’s, Grenada, West Indies

Correspondence to:Joe Iwanaga
Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA 70112, USA
E-mail: iwanagajoeca@gmail.com

Received: October 7, 2020; Revised: October 28, 2020; Accepted: October 29, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The pathogenesis of Chiari 1 malformations has been explained in several different ways, but extensive evidence suggests a relationship between loss of volume within the posterior cranial fossa and Chiari 1 presentations. It is important to be able to differentiate Chiari 1.5 from Chiari 1 malformations as they have similar clinical presentations, but the latter have progressed further and are characterized by caudal herniations of the brain stem through the foramen magnum. Despite the similarities of presentation, Chiari 1.5 malformations have greater rates of complications following posterior decompression surgeries, which are typically performed to relieve ventral compression. An improved understanding of the odontoid synchondroses could lead to better understanding of Chiari malformations and lead to improved treatment of patients with these presentations. Here we present a rare case of an accessory odontoid synchondrosis in a patient with a Chiari 1.5 malformation and ventral compression.

Keywords: Dens, Odontoid process, Anatomy, Chiari malformations, Odontoid synchondroses

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