Teaching NeuroImages: Hypoglossal nerve palsy due to basilar invagination

A woman in her 50s presented to the emergency room with complaints of gait instability. Her examination was notable for tongue deviation to the left. Imaging demonstrated basilar invagination and compression of the preolivary sulci near the cranial nerve 12 nerve root exit zone (figures 1 and 2). Basilar invagination is a rare craniocervical malformation, which can cause neurologic deficits and instability of the craniocervical junction.1,2 Imaging is also notable for platybasia, which is often associated with basilar invagination. The patient underwent a posterior occiput-C3 decompression and fusion without any complications. The patient had a stable neurologic examination on 3-month follow-up.

Source: Neurology - October 23, 2017 Category: Neurology Authors: Bakhsheshian, J., Goshtasbi, K., Acharya, J., Buchanan, I. A., Fredrickson, V., Reid, P. Tags: All Imaging, All Spinal Cord RESIDENT AND FELLOW SECTION Source Type: research