1. The document discusses the anatomy, imaging, and pathologies of the craniovertebral junction. It covers bones, ligaments, embryology, radiographic views and measurements, imaging modalities like CT and MRI, craniometry, congenital anomalies, acquired lesions, and traumatic injuries of this region.
2. Various classifications of fractures and abnormalities are mentioned along with normal variations and measurements. Common conditions discussed include Chiari malformations, basilar invagination, rheumatoid arthritis, and traumatic injuries.
3. Detailed anatomy, measurements, and assessments are provided to evaluate abnormalities seen on imaging of the craniovertebral junction.
This presentation provides a comprehensive review of major sulci of brain which help in defining the different lobes of brain.Very useful for first year residents.
This presentation provides a comprehensive review of major sulci of brain which help in defining the different lobes of brain.Very useful for first year residents.
Anatomy of Brain by MRI
In this presentation we will discuss the cross sectional anatomy of brain. Then we will discuss the Most common diseases to be evaluated by brain imaging.
In my opinion this presentation is a road map for beginars.
Its important to recognise the myelination pattern in neonates and infants. This presentation talks about the myelination pattern and imaging of white matter diseases in children.
Magnetic Resonance Angiography and VenographyAnjan Dangal
Introduction to MR Angiography and Venography Procedure of Brain . Includes Indication, MRI protocol, planning and anatomy as well as brief intoduction to physics behind MRA and MRV principle.
Objectives of this presentation are
Introduction to ct
Cross sectional anatomy
Common important pathologies
This presentation is aimed to educate beginers to help in ct interpretetion.
Slides do curso avançado de atualização em implante de Anel de Ferrara, elaborado por Ferrara Ophtalmics. Para material completo, acesse www.aneldeferrara.com.br
Anatomy of Brain by MRI
In this presentation we will discuss the cross sectional anatomy of brain. Then we will discuss the Most common diseases to be evaluated by brain imaging.
In my opinion this presentation is a road map for beginars.
Its important to recognise the myelination pattern in neonates and infants. This presentation talks about the myelination pattern and imaging of white matter diseases in children.
Magnetic Resonance Angiography and VenographyAnjan Dangal
Introduction to MR Angiography and Venography Procedure of Brain . Includes Indication, MRI protocol, planning and anatomy as well as brief intoduction to physics behind MRA and MRV principle.
Objectives of this presentation are
Introduction to ct
Cross sectional anatomy
Common important pathologies
This presentation is aimed to educate beginers to help in ct interpretetion.
Slides do curso avançado de atualização em implante de Anel de Ferrara, elaborado por Ferrara Ophtalmics. Para material completo, acesse www.aneldeferrara.com.br
Rhinoplasty enhances facial harmony and therefore the proportions of your nose. It will also correct impaired respiration caused by structural defects within the nose.
Rhinoplasty surgery will change:
Nose size in relation to facial balance
Nose width at the bridge or in the dimensions and position of the nostrils
Nose profile with visible humps or depressions on the bridge
Nasal tip that's enlarged or bulbous, drooping, upturned or hooked
Nostrils that are large, wide, or upturned
Nasal asymmetry
If you want a a lot of symmetrical nose, keep in mind that everyone’s face is uneven to some extent. Results may not be utterly symmetric, though the goal is to create facial balance and proper proportion.
rhinoplasty,blepharoplasty,rhinoplasty cost ,rhinoplasty surgery ,best,rhinoplasty surgeon,non surgical rhinoplasty,best rhinoplasty ,nose rhinoplasty,revision rhinoplasty
CT & MRI for CT Surgeons | IACTS SCORE 2020IACTSWeb
This presentation encompasses some of the must-knows of imaging for beginners. Imaging in cardiothoracic surgery is vast and bears a long course in diagnosis, evaluation, follow up and in analyzing outcomes following surgery.
Pre-operative diagnosis in the present milieu of evidence based medicine is based on prudent team work and strong basics. The video tutorial includes planes and views, landmarks for anatomical identification and diagnosis of tetralogy of Fallot, aorto-pulmonary collaterals, coarctation, aortic dissection, atherosclerotic aorta and ulcers, constrictive pericarditis, anomalous pulmonary venous drainage in computed tomography. It also includes the basics of cardiac magnetic resonance (CMR) and its utility in assessing myocardial viability, tissue perfusion, ischaemia, infarction and much more.
The slides was prepared by Dr. Bhavana Nagabhushana Reddy, Consultant Cardiac Radiologist, SSSIHMS Whitefield.
This slide is part of a video which belongs to the lecture series of IACTS SCORE 2020 held at the Sri Sathya Sai Institute of Higher Medical Sciences Whitefield, Bengaluru between 7th and 8th March, 2020.
Similar to cvj radiology BY DR GAURAV CHAUHAN (12)
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
24. WAKENHEIM’s LINE AND ANGLE
WAKENHEIM’s LINE AND ANGLE
•LINESHOULDFALLTANGENTTO POSTERIORASPECTOFTIPOFDENS
•IS FALLSPOST=POSTCRANIOCERVICALDISSOCIATIONANDVICEVERSA
•ANGLEIFLESSTHAN 150,SUSPECTCORDCOMPRESSION
•UPTO150 IN FLEXION,UPTO180IN EXTENSION
25. MCREELINE
Mc REELINE
•DENS SHOULD NOTPROJECTABOVE
• LOWER OCCIPITAL PROTUBERANCE LIE BELOW
THISLINE
•LINE THROUGH DENS SHOULD PASS THROUGH
ANT1/3RD
•NORMAL19to 34mm
•LESS THAN20mm= CORD COMPROMISE
•MORE THAN40mmINCHIARI
26. HEIGHT INDEX OF KLAUS
HEIGHT INDEXOF KLAUS
•< THAN30= BASILARIMPRESSION
•30to 36mm(TENDENCY)
•AVERAGE40– 41mm
63. LARGE CRANIAL VAULT
SMALL SKULL BASE
FLAT NOSE
FRONTAL BOSSING
NARROWFORAMEN MAGNUM
NARROWFORAMEN MAGNUM
SMALL CISTERNAMAGNA
CERVICOMEDULLARYKINK
HIGHUP BRAINSTEM
89. AT THELEVEL OF ENTRYOFVERTEBRAL ARTERYINFTOF ATLAS,MEDIAL EDGE OF
FORAMEN TRANSVERSARIUMTOMIDLINE
AT THELEVEL OF DENSTIP,SHORTESTDISTANCEOF DENS
TOEITHER VERTEBRALARTERIES
AT THELEVEL OF POSTERIORARCHOF ATLAS,MEDIAL EDGE OF VERTBRALARTERYTO MIDLINE
M3
Editor's Notes
INTERNAL OCCIPITAL PROTUBERANCE AND SPHENO OCCIPITALK SYNCHONDROSIS.
LOTS OF ARTICLES AND CHAPTERS ABOUT THE SKULL AND THE CERVICAL SPINE BUT PAUCITY OF LITERATURE ON CVJ
2ND COUNTLESS LINES AND ANGLES AND LINES HAVE BEEN GIVEN WITH WIDE RANGES VARYING BETWEEN AGE AND GENDERS,
AND TO MAKE THE MATTER WORSE VARIOUS TERMINOLOGIES HAVE BEEN INTRODUCES.
BASILAR INVAGINATION IS THE PRIMARY DEVELOPMENTAL ANOMALY,
BASILAR IMPR
7 mm abovw not more than this
5 mm above not more than this
ANGLE POST AXIS LINE AND CLIVAL LINE
150 IN FLEXION
180 IN EXTENSION
IS DFL LESS THAN 150 , CORD COMPRESSION
Tip of odntoid below this line
Macrae’s Line:
Two assessments are then made in relation to this line:
the occipital bone and
the odontoid process.
The inferior margin of the occipital bone
should lie at or below this line. In addition
a perpendicular line drawn through the
odontoid apex should intersect this line
in its anterior quarter.
When effective saggital diameter is <20 mm,
neurological symptoms occur (FM stenosis).
Normal diameter is around 40mm.
The FM is enlarged to >50 mm in c/o Chiari
malformation.
Average (mm) -- 40-41
Minimum (mm) --- 30
A measurement < 30 mm indicates basilar impression. Values between 30 and 36 mm reflect a tendency toward basilar impression
A line is drawn from the tuberculum sellae to the internal occipital protuberance. The vertical distance between this line and the apex of the odontoid is measured. (14) (Fig. 2-9)
Boogard’s line. The basion should lie below this line
Both measurements will be
altered in basilar impression
Boogard’s line. A line is drawn connecting the nasion to the opisthion. (15) (Fig. 2-10A)
Boogard’s angle. (a) A line is drawn between the basion and the opisthion (Macrae’s line). (b) A second line is drawn from the dorsum sellae to the basion along the plane of the clivus. (c) The angle between these two lines is measured.
15 MM
13 MM
Atlanto occipital joint 11 +/-4mm below this line
Tip of odontoid less than 10 mm above this line
If more than 1. then ant occipito atlantal dissociation
In the normal individual the ratio is always < 1.
Bull's angle
<13°
Radiography (Lateral)X-ray computed tomographyMagnetic resonance imaging
Line drawn between the posterior and anterior arch of C1. Bull's angle is the angle between this line and the hard palate plane.
A decreased space is to be expected with advancing age because of degenerative joint disease of the atlantodental joint.
abnormally widened space with reduction in the neural canal size is seen in
Trauma, occipitalization, Down’s syndrome,
pharyngeal infections (Grisel’s disease),
and inflammatory arthropathies (e.g., ankylosing spondylitis, rheumatoid arthritis, psoriatic arthritis, and Reiter’s syndrome)
ATLANTODENTAL INTERSPACE. A. Normal Adult Interspace. The interspace measures < 3 mm (arrows). B. Abnormal Interspace. On flexion a patient with rheumatoid arthritis exhibits anterior translation of the atlas by 5 mm (arrows). C. Normal Childhood Interspace. The interspace measures < 5 mm (arrows). D. CT Scan, Abnormal Interspace. In this patient with rheumatoid arthritis, the atlantodental interspace is increased (arrowheads). Note the erosion at the posterior surface of the odontoid at the site of synovial tissue beneath the transverse ligament
If more than 12 mm, the occipito cervical dissociation is present
125 to 143 degree,
Posterior Cervical Line: If the drawn curve is discontinuous at any level, then an anterior or posterior displacement may be present.
This line is especially useful for detecting subtle odontoid fractures and atlantoaxial subluxation (anterior), which otherwise may be easily overlooked.
A disruption in the middle to lower cervical spine may also be a sign of anterolisthesis, retrolisthesis, or frank dislocation
Atlanto-occipital joint axis angle 124 to 12 degree. If more than 180, severe occipital condyle hypoplasia
CLIVUS CANAL ANGLE LESS THAN 150, SHORTENING OF CLIVUS, VIOLATION OF CHAMBERLEIN LINE
ATLANTOOCCIPITAL JOINT AXIS ANGLE
NRMAL 124 TO 127 DEGREE
THEY GET FLAT IN HYPOPLASTIC OCCIPITAL CONDYLE
4%, IN BIOPSY SPECIMEN, RARE
0.2% ,,,RARER THAN POST ARCH
BERGMAN OSSICLE 12 YEARS. RERMINAL OSSICLE TO THE REMAINDER OF THE DENS.
OS ODONTOIDEUM....INDEPENDENT OSSEOUS STRUCTURE LYING CEPHALAD TO THE BODUY OF THE AXIS, IN POSITION OF THE DENS. SMOOTH XCORTICATED MARGINS AND HYPERTROPHIC ANT ARCH OF THE ATLS.
ASSOCIATED WITH BI, PLATYBASIA AND ATLANTO OCCIPITAL FUSION
NOT ASSOCIATED WITH BI, PLATYBASIA AND ATLANTO OCCIPITAL FUSION
LEMON: INDENTATION OF FRONTAL BONE CHIARI 1
BANANA: CONTENT OF POST FOSSA DISPLACED DOWNWARDS, CISTERNA MAGNA IS OBLITERATED, AND CEREBELLUM WRAPS AROUND BRAINSTEM AS A BANANA.
The radiographic Rigault classification 3,7:
grade I: superomedial angle lower than T2 but above T4 transverse process
grade II: superomedial angle located between C5 and T2 transverse process
grade III: superomedial angle above C5 transverse process
AOI, AAI in downs syndrome due to ligament laxity, altered bone shapes
Posterior atlantodental interval (PADI) measured from the posterior border of the dens to the anterior border of the posterior tubercle. • This index may be more important because it more directly assesses the spinal canal width. • Normal range 19 –32 mm in male & 19 –30mm in females. • Below 19mm, neurological manifestations occur.
The tectorial membrane and alar ligaments pr ,,,, Atlanto-occipital dissociation (AOD) injuries a,,,,
basion-dens interval (BDI) >10 mm in adults 3
basion-axial interval (BAI) >12 mm in adults
Powers ratio >1 (insensitive to a vertical distraction injury or posterior dissociation)
atlantodental interval (ADI)
>3 mm in adult males
>2.5 mm in adult females
Normal values are < 12mm on plain radiographs and <8.5mm on CT 1
BDI AND BAI
Powers ratio is a measurement of the relationship of the foramen magnum to theatlas, used in the diagnosis of atlanto-occipital dissociation injuries.
The ratio, AB/CD, is measured as the ratio of the distance in the median (midsagittal) plane between the:
basion (A) and the posterior spinolaminar line of the atlas (B) and,
opisthion (C) and the anterior arch of the atlas (D)
Normal values are <1 on plain radiographs 1 and <0.9 on CT 2. If this ratio is >1, then the anterior atlanto-occipital dissociation should be suspected.
relatively large cranial vault with small skull base
prominent forehead with depressed nasal bridge
narrowed foramen magnum
cervico medullary kink
relative elevation of the brainstem resulting in a large suprasellar cistern and vertically-oriented straight sinus
communicating hydrocephalus (due to venous obstruction at sigmoid sinus)
LARGE SUPRASELLAR CISTERN
SMALL CISTERNA MAGNA
FRONTAL BOSSING
LARGE CALVARIA
SMALL BASE OF SKULL
NARROW FORAMEN MAGNUM
VERTICAL STRAIGHT SINUS (27 TO 52) AND 55 TO 72
CERVICIOMEDUULLARY KINKING
HIGH UP BRAINSTEM
ENLARGED HEAD CIRCUMFERENCE
OBLITERATION OF SUBARACHNOID SPACE
AAI
J SHAPED SELLA
F MAGNUM NARROWING
DYSPLASTIC CONE SHAPED DENS
RA
EROSION OF DENS
DECREASED FACET JOIMT
INCREASED ADI on flexion
PANNUAS AROUND DENS
INCREASED ADI
IMPINGEMENT OF CERVICOMEDULLARY JUNCTION
DENS EROSION
AAI
ERANAVAT INVAGINATION
BASE DENS EROSION
LATERAL SUBLUXATION
VOULUMINOUS NEW BONE FORMATION
FUSION OF ZYGO APOPHYSEAL JOINTS
ANTERIOR TO C4 7
AAI
OATEITIS AND ENTHESISTIS OF DENS
BONE FORMATION AROUND ATLANTO AXIAL REGION AND DENS
DECREASED ADI
SCLEROSIS
SCLEROSIS SIGNAL LOSS STIR
OSTEOPHTES
DENS EROSION
CALCIFIED PSEUDOMASS OF URATE CRYSTAL BEHIND DENS’ CAN CAUSE SPINAL CORD COMPRESSION
CAN CAUSE SUBLUXATION
DUAL ENERGY CT SHOWING URATE CYRYSTAL
type I fracture (~15%)
impaction fracture of the occipital condyle
due to axial compression
stable injury
type II fracture (~50%)
basilar skull fracture that extends to involve the occipital condyle
due to direct blow to the skull
stable injury
type III fracture (~35%)
avulsion injury of condyle in region of alar ligament attachment
due to forced contralateral bending and rotation
potentially unstable injury
IN RA AND DOWNS
IN CHILDREN BECAUSE OF MORE HORIZONTAL OCCIPITAL CONDYLE
FLEXION INJURY ME ANTERIOR SUBLUXATION
HYPEREXTENSION INJURY ME POST SUBLUXATION
CAN BE LONGITUDINAL DUISTRATCION
POWERS RATION IF MORE THAN 1 === ANTERIOR SUBLUXATION
WAKENHEIM NLINE IF FALLS POSTERIORLY TO DENS THEN POST SUBLUCATION
ATLAS OCCIPUT DISTANCE SHOULD BE LESS THAN 5 MM ALWAYS
The Jefferson fracture most commonly occurs as the result of axial loading on the head through the occiput, leading to a burst-type fracture of C1.
Steele's Rule of Thirds: - canal of atlas is about 3 cm in its AP diameter; - spinal cord, odontoid process, and free space for cord are each about 1 cm in diameter; - anterior displacement of the atlas that exceeds one centimeter may jeopardize the adjacent segment of the spinal cord;
ANTERIOR ARCH FRACTURE ONLY 2 PERCENT, ASSOCIATED WITH DENS FRACTURE
POSTERIOR ARCH FRCTURE IS MORE COMMON, ASS WITH HTYPEREXTENSION
TRANSVERSE LIGAMENT INJURY
DENS SHIFTS POSTERIORLY
AND COMPRESSES THE SPINAL CORDD
Hangman fracture (also known as traumatic spondylolisthesis of axis) is a fracture which involves the pars interarticularis of C2 on both sides, and is a result of hyperextension and distraction.
lassification
type I: fracture with <3 mm antero-posterior deviation
no angular deviation
type II: fracture with >3 mm antero-posterior deviation
significant angular deviation
disruption of posterior longitudinal ligament
type IIa: the fracture line is horizontal/oblique (instead of vertical)
significant angular deviation without anterior translation
type III: type I with bilateral facet joint dislocation
Aneurysmal bone cyst of the axis
This rapidly growing, expansile, multilocular
lesion replacing the body of the axis proved
histol
METS: LUNG, BREAST, PROSTATE
Vertebral artery (VA) injury may occur in approximately 4.1% patients during surgery at the craniovertebral junction (CVJ
M1: TIP OD ODONTOID AND HARD PALATE LEVEL , DISTANCE OF VERTEBRAL ARTERY AND DENS
M2: AT THE LEVEL OF THE ENTRY OF VA INTO THE FT OF THE ATLAS: MEDIAL EDGE OF FORAMEN TRANSVERSARIUM AND MIDLINE
M3: AXIAL PLANE AT THE LEVEL OF POST ARCH OF ATLAS: MEDIAL EDGE OF VA AND MIDLINE