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Daniel D. Cavalcanti, Nikolay L. Martirosyan, Ketan Verma, Sam Safavi-Abbasi, Randall W. Porter, Nicholas Theodore, Volker K. H. Sonntag, Curtis A. Dickman and Robert F. Spetzler

T he craniocervical junction (CCJ) is defined as the region comprising the clivus, foramen magnum, atlas, and axis. 25 , 40 This site is a potential location for several neoplastic diseases. Meningiomas and chordomas are the most frequent histopathological diagnoses. Schwannomas, paragangliomas, chondrosarcomas, plasmacytomas, and metastatic tumors are other possible findings. Schwannomas represent 5%–10% of all intracranial tumors. 41 , 57 Intracranial schwannomas can arise from any CN but most commonly involve the vestibular portion of CN VIII, with

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Eric M. Horn, Iman Feiz-Erfan, Gregory P. Lekovic, Curtis A. Dickman, Volker K. H. Sonntag and Nicholas Theodore

O ccipitoatlantal dislocation is a rare traumatic injury associated with a high rate of mortality and significant neurological morbidity. 5 , 7 , 14 , 17 , 19 , 23 , 25 , 36 , 37 , 51 , 52 As prehospital care has improved during the past 20 years, more patients who sustain OAD have survived a long enough duration to be transferred to a trauma hospital. 46 The frequent use of MR imaging to evaluate patients who have sustained trauma has heightened awareness of soft-tissue and ligamentous abnormalities of the craniocervical junction, especially in

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Michael A. Mooney, Mark E. Oppenlander, U. Kumar Kakarla and Nicholas Theodore

progressive radiculomyelopathy—case report . Neurol Med Chir (Tokyo) 41 : 411 – 414 , 2001 10.2176/nmc.41.411 11561354 21 Mayr MT , Hunter S , Erwood SC , Haid RW Jr : Calcifying pseudoneoplasms of the spine with myelopathy. Report of two cases . J Neurosurg 93 : 2 Suppl 291 – 293 , 2000 11012062 22 Menezes AH , VanGilder JC : Transoral-transpharyngeal approach to the anterior craniocervical junction. Ten-year experience with 72 patients . J Neurosurg 69 : 895 – 903 , 1988 10.3171/jns.1988.69.6.0895 3193195 23 Mooney JF III , Glazier

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Mehmet Senoglu, Sam Safavi-Abbasi, Nicholas Theodore, Nicholas C. Bambakidis, Neil R. Crawford and Volker K. H. Sonntag

., 2001 1 C & anterior cleft none Urasaki et al., 2001 1 A transient quadriparesis Torriani & Lourenco, 2002 1 E none Gangopadhyay & Aslam, 2003 1 B none Klimo et al., 2003 1 C transient quadriparesis Garg et al., 2004 1 A transient quadriparesis O'Sullivan & McManus, 2004 1 D none Schrödel et al., 2005 1 E none Sagiuchi et al., 2006 1 D transient quadriparesis *According to Currarino et al. The discovery of a craniocervical junction malformation that requires management includes

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Eduardo Martinez-del-Campo, Jay D. Turner, Leonardo Rangel-Castilla, Hector Soriano-Baron, Samuel Kalb and Nicholas Theodore

children: the occipitocervical crankshaft phenomenon . J Pediatr Orthop 17 : 762 – 765 , 1997 50 Rojas CA , Bertozzi JC , Martinez CR , Whitlow J : Reassessment of the craniocervical junction: normal values on CT . AJNR Am J Neuroradiol 28 : 1819 – 1823 , 2007 51 Sawin PD , Traynelis VC , Menezes AH : A comparative analysis of fusion rates and donor-site morbidity for autogeneicrib and iliac crest bone grafts in posterior cervical fusions . J Neurosurg 88 : 255 – 265 , 1998 52 Schultz KD Jr , Petronio J , Haid RW , Rodts

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Rogerio Rocha, Sam Safavi-Abbasi, Cassius Reis, Nicholas Theodore, Nicholas Bambakidis, Evandro De Oliveira, Volker K. H. Sonntag and Neil R. Crawford

and causes significant bleeding. 10 The ICA also may be at risk during bicortical screw fixation of the atlas. Currier et al. 6 have indicated that the location of the ICA relative to the anterior aspect of the atlas may vary considerably and that this vessel may be located within 1 mm of the ideal exit point of the bicortical C-1 lateral mass screw. During procedures involving the craniocervical junction, one should anticipate asymmetry and variability of the VA. 1 Moreover, in some cases the VA must be dissected away from the surgical field for application of

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Luis Perez-Orribo, Laura A. Snyder, Samuel Kalb, Ali M. Elhadi, Forrest Hsu, Anna G. U. S. Newcomb, Devika Malhotra, Neil R. Crawford and Nicholas Theodore

accident, 5 (4%) were injured in a diving accident, and 1 (0.8%) was injured during American football practice ( Fig. 4 ). Twenty patients (16%) had medical conditions specifically related to the craniocervical junction. Five patients (4%) had rheumatoid arthritis, 11 (8.8%) had bony metabolic diseases, 3 (2.4%) had ankylosing spondylitis, and 1 (0.8%) had Down syndrome. FIG. 4. Distribution of injury mechanisms in the 125 patients studied. MVA = motor vehicle accident. At their initial clinical examination, 87 patients (72.5%) had a GCS score of 15, 26 (21

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. Given our small cohort of patients treated without orthosis, it is possible that isolated OCF may be treated without cervical orthosis at all. Neurosurg Focus Neurosurgical Focus FOC 1092-0684 American Association of Neurological Surgeons 10.3171/2017.3.FOC-DSPNabstracts 2017.3.FOC-DSPNABSTRACTS Kline Peripheral Nerve Award Presentation 166. A Finite Element Analysis of the Occitipoatlantal Capsular Ligaments as the Primary Stabilizers of the Craniocervical Junction Andrew T. Dailey , MD , Rinchen Phuntsok