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Lars de Jong, Michiel Verfaillie, Steven Pans, Philippe Lauweryns, Jan Goffin and Bart Depreitere

subsequent myelopathy. Severe degeneration of the C1–2 joints may rarely produce a similar condition. In this paper, we report the medical history of two 70-year-old monozygotic twin sisters who both suffered from severe atlantoaxial instability and had identical radiographic features. Signs of inflammatory or metabolic disease, clear congenital disorders, or traumatic injuries could not be identified. Had either sister been a solitary case, degenerative atlantoaxial instability would have been the most straightforward diagnosis. In this case, however, the question

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Gurpreet S. Gandhoke, Ezequiel Goldschmidt, Robert Kellogg and Stephanie Greene

( Fig. 1H ) views demonstrate good retraction of the encephalocele in the posterior fossa. Discussion No prior case of a prenatally diagnosed meningocele becoming an encephalocele by the time of delivery has been reported. Such a phenomenon may occur earlier in the gestation period than can be identified with current imaging modalities, but this case occurred late enough to be readily identifiable. Congenital encephaloceles classically contain gliotic neural tissue on pathological analysis; this tissue is routinely resected without neurological sequelae to close the

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Pravin Salunke, Manish Sharma, Harsimrat Bir Singh Sodhi, Kanchan K. Mukherjee and Niranjan K. Khandelwal

. 1 The genesis of congenital RAAD was thought to be different. 2 , 14 The inferior sagittal C-1 facet angles in RAAD patients are slightly acute in comparison with those in control individuals. Therefore, in the presence of lax ligaments, a congenital absence of the transverse ligament, or a short peglike odontoid or os odontoideum, there may be dislocation of the C1–2 facet joint. As the facet angle is relatively flat, it returns to the normal position on extension. Thus, it appears that RAAD and IrAAD may be part of the same spectrum. In healthy individuals

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Kirpal S. Mann, Virender K. Khosla and Des R. Gulati

T he spontaneous development of a communication between the ventricular system and the subarachnoid space proximal to the site of obstruction in obstructive hydrocephalus, leading to amelioration of symptoms, is a rare phenomenon. To date, only eight well documented cases have been reported. 1, 3, 8, 9, 11, 14–16 No previous case of congenital ventriculocisternostomy has been reported. We are presenting a case in which a communication between the floor of the third ventricle and the interpeduncular cistern was demonstrated by Conray ventriculography

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Mehdi Zeinalizadeh, Seyed Mousa Sadrehosseini, Zohreh Habibi, Farideh Nejat, Harley Brito da Silva and Harminder Singh

A congenital encephalocele is defined as a herniation of cranial contents through a cranial defect in a patient with a medical history negative for secondary causes. 17 Basal encephaloceles are rare, with an estimated incidence of 1 in every 35,000 live births. They are classified into transethmoidal, sphenoorbital, sphenomaxillary, and transsphenoidal. 19 Transsphenoidal encephaloceles are the rarest of the rare, accounting for 5% of basal herniations, and having an estimated incidence of 1 in 700,000 live births. 7 Transsphenoidal encephaloceles have

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Nicholas Boyko, Melissa Ann Eppinger, Deborah Straka-DeMarco and Catherine Anne Mazzola

C ongenital torticollis presents with lateral neck flexion and neck rotation to the opposite side, as shown in Fig. 1 . The incidence of torticollis has been reported to be as high as 8.2%–16%, 9 , 15 but it is more commonly reported as between 0.3% and 3.92%. 4 , 5 , 7 , 8 , 14 , 16 The cause of congenital torticollis may be due to an abnormal position of the intrauterine fetus or fetal head descent causing trauma to the sternocleidomastoid muscle or its innervation. 7 , 9 Birth trauma may result in compartment syndrome, which is characterized by ischemia

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Brian J. McHugh, Ryan A. Grant, Alyssa B. Zupon and Michael L. DiLuna

O s odontoideum is a well-described abnormality of the axis, consisting of an independent bony ossicle with smooth cortical margins separated from a hypoplastic dens. 21 This anomaly was initially described in 1886 8 and has generated significant debate regarding its etiology since its conception. Currently, there are 2 prevailing theories—congenital versus posttraumatic, 3 , 22 with the latter favored; however, some authors argue that elements of both theories represent the actual etiology. 17 To demonstrate this multifactorial etiology, we present a

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Jetan H. Badhiwala, Eric M. Thompson, Armando J. Lorenzo and Abhaya V. Kulkarni

lack of understanding of the natural history of this condition. We report on two male infants with SLC who experienced spontaneous improvement of lower urinary tract dysfunction, providing further insights into the variable natural history of this congenital anomaly. Case Reports Case 1 History and Examination This male infant presented shortly after birth with a subcutaneous mass and two small overlying cutaneous hemangiomas in the lower lumbar region. The infant appeared to be urinating and defecating without any issues. Neurological examination

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Ingrid Kieran, Zaitun Zakaria, Chandrasekaran Kaliaperumal, Declan O'Rourke, Alan O'Hare, Eoghan Laffan, John Caird, Mary D. King and Dylan J. Murray

N oninvoluting congenital hemangiomas (NICHs) are described as part of the spectrum of vascular tumors. 3 They differ from rapidly involuting congenital hemangiomas, which proliferate rapidly in the 1st year of life and then gradually regress over the following 5 to 10 years. NICHs in contrast, fail to involute and histologically stain negative for glucose transporter protein 1 (GLUT-1). 6 Hemangiomas are proliferative vascular lesions characterized by increased endothelial cell turnover, and NICHs therefore can result in large and highly vascularized

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Akash J. Patel, Sudhakar Vadivelu, Sohum K. Desai and Andrew Jea

T he congenital absence or hypoplasia of a spinal pedicle is an anomaly most commonly occurring in the cervical or thoracic spine. The absence of a lumbar or sacral pedicle is extremely rare. 2 , 4–6 , 14 , 15 , 21 Most cases of absent or hypoplastic lumbosacral pedicles are asymptomatic and usually found incidentally on diagnostic imaging. When this anomaly does come to clinical attention, low-back pain is the only associated symptom reported thus far. 5 To the best of our knowledge, our 2 cases are the first instances of the absence or hypoplasia of