Ayesha Khalid, Khalid A Sethi, Inayatullah Khan, Ismail A Khatri, Saleem Malik, Arsalan Ahmad.
Basilar invagination - impending sudden death - report of a life saving surgery.
Pak J Neurological Sci Jan ;4(2):68-71.

Introduction: Basilar invagination is an uncommon syndrome that occurs when the superior part of odontoid (C2) migrates upward. It occurs both congenitally and in bone/joint diseases. It may lead to static or dynamic stenosis of the foramen magnum, and compression of medulla oblongata, which may manifest clinically as sudden death from brainstem compression. Case Report: A 25-year-old man presented with gradually progressive weakness of right arm and left leg for six months, associated with walking difficulty. MRI brain revealed atlanto-axial sublaxation with posteriorly subluxed odontoid peg causing severe compression and posterior displacement of brainstem. MRI of spine showed extensive syringohydromyelia. He underwent trans-oral odontoidectomy, and posterior fusion, followed by a halo traction. We report a marathon life saving surgery done at our institution that to our knowledge has not been reported from Pakistan.

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