BASILAR IMPRESSION

• Published in: Nippon Jibi Inkoka Gakkai Kaiho Vol. 68; no. 2; pp. 230 - 243
• Main Authors: KANEKO, HIROSHI, KIMURA, KIKUO, KAMEI, TAMIO, NORO, HISAKIMI, KAWABUCHI, JUNICHI, USHIO, AKIRA, KASAHARA, KOICHI
• Format: Journal Article
• Language: English
• Published: The Oto-Rhino-Laryngological Society of Japan, Inc 1965
• ISSN: 0030-6622; 1883-0854
• DOI: 10.3950/jibiinkoka.68.230

1) Three cases of basilar impression are presented with the review of the literatures. 2) The deformity is of a rare congenital origin, and is characterized by a flattening of the base of the skull and by an invagination of the upper cervical spine into the posterior fossa. In addition to the above mentioned findings the patients were accompanied with the following: torticollis, occipitalization, Klippel-Feil syndrome and deformed foramen magnum (a female aged 42 years); torticollis, platybasia and narrowing of the space between the atlas and the occiput (a female aged 17) torticollis, occipitalization, deformed foramen magnum, asymmetry of the skull, digital impression, hypertelorism and bifid spinae of both the 3rd and 4th cervical vertebrae (a female aged 28). 3) All patients revealed symptoms and signs of involvement of the cerebellum and medulla including nystagmus, signs of compression of lower cranial as well as upper cervical nerves of both motor and sensory, vertigo, hoarseness and dysphagla. 4) The spontaneous nystagmus of the present cases were of the so-called central type with large vertical as well as oblique components. Vertical nystagmus was observed more markedly by provocation techniques such as quick positioning of the body (Dix-Hallpike and Stenger) or head shaking. Although the final diagnosis must be done roentgenologically, the authors stress the findings of nystagmus as an early symptom. 5) Two of the three present cases have been treated surgically (suboccipital craniectomy and decompression) with favourable results except for the findings of nystagmus. 6) The review of the literatures is made. A few reports are found, in which reporters had observed such nystagmus in detail. The patients with basilar impression have to be examined not only neurologically and roentgenologically, but also otolaryngologically, especially about vestibular function.