The proatlas: a comprehensive review with clinical implications

Muhleman, Mitchel; Charran, Ordessia; Matusz, Petru; Shoja, Mohammadali Mohajel; Tubbs, R. Shane; Loukas, Marios

doi:10.1007/s00381-012-1698-8

Cited by 22 publications

(12 citation statements)

References 20 publications

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“…The anterior landmarks for FM have been the lower third of the clivus and upper edge of the body of C26). The anterior tubercle of the clivus is derived from the hypocentrum of the proatlas, while the apex of the odontoid process of the axis is derived from the centrum of the proatlas16). We can infer that FM is an extension of the spinal canal.…”

Section: Discussionmentioning

confidence: 99%

Conventional Posterior Approach without Far Lateral Approach for Ventral Foramen Magnum Meningiomas

Sohn

Chung

2013

J Korean Neurosurg Soc

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ObjectiveWe present our experience of conventional posterior approach without fat lateral approach for ventral foramen magnum (FM) meningioma (FM meningioma) and tried to evaluate the approach is applicable to ventral FM meningioma.MethodsFrom January 1999 to March 2011, 11 patients with a ventral FM meningioma underwent a conventional posterior approach without further extension of lateral bony window. The tumor was removed through a working space between the dura and arachnoid membrane at the cervicomedullary junction with minimal retraction of medulla, spinal cord or cerebellum. Care should be taken not to violate arachnoid membrane.ResultsPreoperatively, six patients were of Nurick grade 1, three were of grade 2, and two were of grade 3. Median follow-up period was 55 months (range, 20-163 months). The extent of resection was Simpson grade I in one case and Simpson grade II in remaining 10 cases. Clinical symptoms improved in eight patients and stable in three patients. There were no recurrences during the follow-up period. Postoperative morbidities included one pseudomeningocele and one transient dysphagia with dysarthria.ConclusionVentral FM meningiomas can be removed gross totally using a posterior approach without fat lateral approach. The arachnoid membrane can then be exploited as an anatomical barrier. However, this approach should be taken with a thorough understanding of its anatomical limitation.

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Section: Discussionmentioning

confidence: 99%

Conventional Posterior Approach without Far Lateral Approach for Ventral Foramen Magnum Meningiomas

Sohn

Chung

2013

J Korean Neurosurg Soc

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“…These most commonly include a prebasilar third occipital condyle, a partial regressive occipital vertebra, or an ossiculum terminale. 15,16 The proatlas segment remnant in our patient represents a developmental anomaly of the hypocentrum and centrum of the fourth occipital sclerotome. The former develops into the anterior tubercle of the clivus, and the latter forms the apical dens segment.…”

mentioning

confidence: 74%

“…Of the 42 somites, the craniocervical junction is formed by 4 occipital and the first 2 cervical sclerotomes. 16 The first 2 occipital sclerotomes give rise to the basiocciput, and the third sclerotome develops into the jugular tubercles. The fourth occipital sclerotome or the proatlas segment normally develops into the anterior clival tubercle, the apical odontoid segment, parts of the foramen magnum margin, and the atlantal masses.…”

Section: Proatlas Segmentation Anomalymentioning

confidence: 99%

Clinical presentation and management of proatlas segmentation defect presenting with palatal myoclonus: case report

Ahmed

Menezes

2015

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Clinical presentation of craniovertebral junction disorders may range from acute catastrophic neurological deficits to insidious signs and symptoms that may mask the underlying etiology. Prompt recognition and treatment is essential to avert long-term neurological morbidity. Proatlas segmentation disorders are a rare group of developmental disorders involving the craniocervical junction. Abnormal bony segmentation leads to malformed bony structures that can in turn lead to neurological deficits through bony compression of the cervicomedullary junction. This report details a proatlas segmentation defect presenting as palatal myoclonus, a rare movement disorder. The clinical presentation, surgical management, and neuroanatomical basis for the disorder is presented. This report highlights the myriad clinical presentations of craniovertebral disorders and emphasizes a rare but treatable etiology for palatal myoclonus.

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“…The proatlas is a rudimentary vertebral structure and precursor of the craniocervical junction, formed from the fourth occipital sclerotome [7,8]. This structure gives rise to the apex of the odontoid process in addition to sections of the atlas and both the apical and alar ligaments [6,9]. However, the body of the odontoid process originates from the centrum formed from the first spinal sclerotome, which also forms most of the atlas.…”

Section: Embryogenesismentioning

confidence: 99%

Duplication of the odontoid process with other congenital defects of the craniocervical Junction: case report and review of the literature

et al. 2020

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Duplication of the odontoid process remains a rare developmental pathology that is underrepresented in the current literature. As the pivot point for the craniovertebral junction, the odontoid process is vital for the integrity of the atlanto-axial joint and the ability of the head and cervical spine to rotate correctly. The pathogenesis being incompletely understood, it has been proposed that odontoid process duplication involves faulty sclerotome migration and disruption of the axis ossification center. Patients presenting with this pathology usually have associated structural abnormalities. A detailed anatomical and embryological understanding of the odontoid process is necessary for successful management and treatment of patients presenting with odontoid process duplication. We present a rare case of a patient with a duplicated odontoid process in association with C2-C3 fusion, incomplete anterior arch of C1, variant inferior bony process of the transverse process of C1, and enlarged right jugular foramen.

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The proatlas: a comprehensive review with clinical implications

Abstract: This paper will discuss the development of the proatlas and the resultant anomalies associated with its failure to merge with the occipital sclerotomes to form the occipital bone. In addition, some consideration of comparative anatomy and surgical techniques will be presented.

Cited by 22 publications

References 20 publications

Conventional Posterior Approach without Far Lateral Approach for Ventral Foramen Magnum Meningiomas

Conventional Posterior Approach without Far Lateral Approach for Ventral Foramen Magnum Meningiomas

Clinical presentation and management of proatlas segmentation defect presenting with palatal myoclonus: case report

Duplication of the odontoid process with other congenital defects of the craniocervical Junction: case report and review of the literature

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