Two Cases with Congenital Anomaly of the Upper Cervical Vertebra

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The localisation of neurological findings in the spinal cord of the upper cervix is often unprecise and compression of the cord, especially due to congenital anomaly of the cervical spine, is often not recognised at first.A woman, twenty-one years old, suffered from disturbance of gait and skilled movement in the hands. At first she was diagnosed as cerebral palsy. There were no abnormal findings at birth and early infancy. She began to walk at eleven months, but tended to fall often.Cranial nerves are not affected but spasticity in the limbs exists.The lateral Roentgenogram of the neck showed a separated odontoid process which in flexion and extension demonstrated an abnormal range of motion.Congenital anomaly is often asymptomatic, but narrowing of the cervical canal with cord compression may occur.The investigation of any case of spasticity in all four limbs must therefore include a detailed Roentgenological assessment of the cervical spine.Congenital anomaly of the upper cervical spine is often recognised only because of symptoms which follow various types of traumas to the head or neck; otherwise this anomaly would go unnoticed.A man, twenty-four years old, started to have neck pain, headache, tinnitis and dizziness after a whiplash injury. No neurological signs were present at the time. Roentgenograms of the neck however showed developmental failure of the posterior arch of the atlas.