What is Craniocervical Instability?
Craniocervical instability is a pathological deformity of the brainstem , upper spinal corduroy and cerebellum that causes structural instability of the craniocervical junction . It is also known as the syndrome of occipitoatlantoaxial hypermobility . It is a common determination in person affected byEhlers - Danlos syndrome .
Ehlers - Danlos Syndrome is a rare genetic purchase order characterized by abnormal or defective product of the collagen . There may be a structural defect in the collagen or a fault with the proteins that binds with the collagen . symptom admit hypermobility of juncture , stretchable peel , easy tearing of skin , vascular fragility and increase endangerment of develop cardiovascular complication such asaneurysms .
Symptoms of Craniocervical Instability
Other rough-cut symptoms of craniocervical unbalance include :
Prognosis of Craniocervical Instability
Craniocervical unstableness when diagnose early can be treat and the condition can be reversed . In severe cases , craniocervical instability causes lasting impairment and nerve damage .
Causes and Pathophysiology of Craniocervical Instability
Craniocervical instability is because of absence of connective tissue support at the craniocervical join . This is commonly see in patient with Ehlers - Danlos syndrome . The risk of develop craniocervical instability step-up with vulnerability to head word and neck injury and other insistent stretch injury . This can be cause by simple insistent injury such as turning his or her head . Stretch injury may lead to craniocervical imbalance in the next ways :
Risk Factors of Craniocervical Instability
The hazard factors include
Diagnosis of Craniocervical Instability
Most of the histopathological changes may not be take down on quotidian symptomatic changes . MRI taken in an upright position may be helpful in certain conditions . Rotational three-D CT scan is quite helpful in diagnosing of craniocervical instability . In some cases , invasive cervical traction may be used . It is a procedure where the individual ’s head teacher is pull out by a pulley up over a course of action of 48 hours . Physical examination may be done by an experient doctor to arrive at a finale . The affected role ’ head teacher may be physically deplume upwards or downwards to contain for pain , soreness and tenderness .
Treatment of Craniocervical Instability
The treatment modality for Craniocervical Instability includes cervical traction followed by cervical optical fusion . The read/write head is pulled upwards automatically and wreak to the right anatomical posture . to harbour the structure at the correct military position , the occipital os is commingle with the upper cervical vertebrae . Titanium hardware , pearl grafts or morphogenic proteins may be used for this routine . Post - surgical immobilisation is suggested for utter fusion of the bones . A cervical brace , annulus singlet or custom-make Minerva may be given to maintain a neutral carriage and restrict mobility until there is everlasting healing . In some cases electrocautery may be used to shrivel the cerebellar faucial tonsil . This also improves occlusion of rate of flow of cerebrospinal fluid .
Craniocervical instability is a condition characterised by misshapenness and instability of the craniocervical conjugation . Craniocervical instability is commonly associate with Ehlers - Danlos syndrome and other connective tissue paper syndrome . Craniocervical instability is due to lack of reenforcement at the craniocervical junction leading to concretion over the Einstein stem . Craniocervical imbalance is reversible if detected early on . However , if left untreated it can leave to permanent malformation .
