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Samuel F. Ciricillo and Philip R. Weinstein

✓ The authors report a case of progressive foramen magnum syndrome due to deposits of calcium pyrophosphate dihydrate crystals, which caused reactive hypertrophy in the posterior longitudinal ligament at C-1 and in the transverse ligament of the atlas in an 84-year-old woman. This is the first reported case of symptomatic pseudogout in this anatomic location. Rapid neurological recovery followed transoral decompression of the cervicomedullary junction.

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.71.1.0138 Foramen magnum syndrome from pseudogout of the atlanto-occipital ligament Samuel F. Ciricillo Philip R. Weinstein July 1989 71 1 141 143 10.3171/jns.1989.71.1.0141 A temporal approach to anterior communicating artery aneurysms Charles E. Poletti July 1989 71 1 144 146 10.3171/jns.1989.71.1.0144 J Neurosurg Journal of Neurosurgery 0022-3085 Journal of Neurosurgery Publishing Group 1 7 1989 July 1989 71 1 10.3171/jns.1989.71.issue-1

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Roberto Pallini, Lauretti Liverana, Larocca Luigi Maria, Colosimo Cesare, Fernandez Eduardo and Ramesh Babu

the atlanto-occipital ligament. Case report. J Neurosurg 71 : 141 – 143 , 1989 Ciricillo SF, Weinstein PR: Foramen magnum syndrome from pseudogout of the atlanto-occipital ligament. Case report. J Neurosurg 71: 141–143, 1989 2. Crockard HA , Sett P , Geddes JF , et al : Damaged ligaments at the craniocervical junction presenting as an extradural tumour: a differential diagnosis in the elderly. J Neurol Neurosurg Psychiatry 54 : 817 – 821 , 1991 Crockard HA, Sett P, Geddes JF, et al: Damaged

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Treatment of pedicular fractures of the axis

A clinical study and screw fixation technique

Guy M. Borne, Gerard L. Bedou and Magloire Pinaudeau

knowledge of the movements taking place at each level is important in understanding the mechanisms leading to lesions of C-2, and particularly to lesions of the pedicle-isthmus complex at this level. Flexion-extension and lateralization movements take place at the upper level, which comprises the atlantooccipital joint. Flexion beyond 20° is limited by the lateral atlanto-occipital ligament, the lateral alar-odontoid ligaments, and the vertical limb of the cruciform ligament. Extension is limited to 30° by the anterior longitudinal ligament and the contact between the

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John Litvak, Thomas C. Sumners, James L. Barron and Larry S. Fisher

constrictor muscle is ready for insertion into the clival-atlas defect (dotted lines). Lower Right: The muscle flap fills the bone-dural defect with V-plasty mucosal closure. Following this retraction, the superior pharyngeal musculature, including the longus capitis, rectus capitis anterior, and longus coli was retracted laterally with an articulated Weitlaner retractor. The anterior atlanto-occipital ligament and membrane were incised in the midline, and elevated laterally. The anterior rim of the foramen magnum was identified using the C-arm image intensifier

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Bernhard Zünkeler, Robert Schelper and Arnold H. Menezes

Y , Panush RS : CPPDDD: what it is and why it is under-recognized. Bull Rheum Dis 44 : 3 – 5 , 1995 Chuzin Y, Panush RS: CPPDDD: what it is and why it is under-recognized. Bull Rheum Dis 44: 3–5, 1995 2. Ciricillo SF , Weinstein PR : Foramen magnum syndrome from pseudogout of the atlanto-occipital ligament. Case Report. J Neurosurg 71 : 141 – 143 , 1989 Ciricillo SF, Weinstein PR: Foramen magnum syndrome from pseudogout of the atlanto-occipital ligament. Case Report. J Neurosurg 71: 141

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William S. Rosenberg, Andrew E. Rosenberg and Charles E. Poletti

Neurol 29: 149–152, 1988 3. Brooks JJ , LiVolsi VA , Trojanowski JQ : Does chondroid chordoma exist? Acta Neuropathol 72 : 229 – 235 , 1987 Brooks JJ, LiVolsi VA, Trojanowski JQ: Does chondroid chordoma exist? Acta Neuropathol 72: 229–235, 1987 4. Ciricillo SF , Weinstein PR : Foramen magnum syndrome from pseudogout of the atlanto-occipital ligament. Case report. J Neurosurg 71 : 141 – 143 , 1989 Ciricillo SF, Weinstein PR: Foramen magnum syndrome from pseudogout of the atlanto-occipital

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Takeo Shimizu, Shiro Waga, Tadashi Kojima and Shigehiko Niwa

type of neck trauma. 27, 30, 35, 37, 53 The mechanisms of such injuries involve excessive rotation of the neck with or without cervical hyperextension. Even repeated voluntary neck exercise during archery, 46 hunting, 3 swimming, 50 softball, 15, 23 baseball, skiing, 4, 39 yoga, 18, 31 calisthenics, 16, 31 diving, 44 and ceiling painting 32 may cause vertebrobasilar ischemic attacks. In the case reported here, repeated rotational movement following minor neck injury may have brought about thickening of the atlanto-occipital ligament, thus fixing the

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Jennifer L. Quon, Ryan A. Grant and Michael L. DiLuna

compared pre- and postoperatively, when available, and assessed on all patients postoperatively to confirm adequate CSF flow. Postoperative MRI with cine was obtained approximately 3 months after surgery. Surgical Technique All 18 patients underwent extradural surgical CM-I decompression in the prone position. A standard suboccipital craniectomy was performed to ensure a wide decompression of the cerebellar hemispheres, brainstem, and midline structures. In all cases, a C-1 laminectomy was also performed to decompress the cervical spinal cord. The atlanto-occipital

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Vincent C. Traynelis, Gary D. Marano, Ralph O. Dunker and Howard H. Kaufman

ligaments, and the two lateral atlanto-occipital ligaments unite the atlas with the cranium. The cruciate ligament (a longitudinally oriented structure associated with the transverse ligament of the atlas) also contributes some strength to this articulation. However, it is a second group of ligaments that provides the major structural support for the craniocervical junction. This group of ligaments, which run from the occiput to the axis, include the apical dental ligament, the paired alar ligaments, and the broad tectorial membrane ( Fig. 3 ). Fig. 3. Ligamentous and