‘Congenital anomalies of craniovertebral junction presenting after 50 years of age’: An oxymoron or An unusual variation?

Salunke, Pravin; Karthigeyan, Madhivanan; Sunil, N; Rangan, Vasundhara

doi:10.1016/j.clineuro.2017.12.015

Cited by 5 publications

(2 citation statements)

References 17 publications

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“…However, many patients follow a relatively asymptomatic and chronic clinical picture and usually present later in the course of the disease. [ 17 18 ] Knowing amount ANS dysfunction in the preoperative period may help in predicting the prognosis in the long run. Furthermore, patients having progressive ANS dysfunction even though subclinical may warrant early intervention for better long-term outcomes.…”

Section: Discussionmentioning

confidence: 99%

Six-year longitudinal prospective comparative study between preoperative and postoperative heart rate variability indices in congenital craniovertebral junction anomalies

Devi

Siroya

Bhat³

et al. 2022

Journal of Craniovertebral Junction and Spine

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Background: Craniovertebral junction (CVJ) anomalies involve mosaic interaction of multifaceted neurovascular and bony elements. Most of them present late in the course of illness usually as acute presentations following trivial trauma. Knowing subclinical autonomic dysfunction in such anomalies when managed medically can not only indicate progression but also provide en route to early intervention for better outcomes, especially in relatively asymptomatic patients. Materials and Methods: We conducted a 6-year longitudinal prospective study including 40 consecutive patients of CVJ anomalies with clinical, radiological, and heart rate variability (HRV) parameters and found their correlation in preoperative and follow-up period. Results: Twenty-eight patients were male and the rest were female. The mean age was 32 years with the least age being 8 years and maximum age being 75 years old. Mean Nurick's grade and Barthel's index were 1.8 and 83.75, respectively. 38% had severe-to-moderate compression. The mean follow-up was 17.4 months. Both sympathetic and parasympathetic oscillator HRV indices were significantly affected in the preoperative period ( P ≤ 0.001) with no association with Nurick's grade or degree of compression although there was association with grade of Barthel's index. Poincare plots showed “fan,” “complex,” or “torpedo” patterns in 36 patients. Forty patients had both preoperative and follow-up clinical grade whereas 22 patients HRV tests in the above periods. None of the HRV indices showed significant improvement at follow-up. Nonetheless both sympathetic and parasympathetic did improve at follow-up with sympathetic tone registering better scores. Poincare plots showed improvement toward “comet” patterns in all patients. Conclusion: HRV indices not only help in prognosticating but may also help in predicting outcomes.

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Section: Discussionmentioning

confidence: 99%

Six-year longitudinal prospective comparative study between preoperative and postoperative heart rate variability indices in congenital craniovertebral junction anomalies

Devi

Siroya

Bhat³

et al. 2022

Journal of Craniovertebral Junction and Spine

View full text Add to dashboard Cite

show abstract

“…BI combined with AAD is a common congenital deformity of the craniocervical junction (CVJ) without known etiology [ 1 ]. Direct posterior reduction and manipulation of the C 1-2 joints followed by fusion and fixed with spacers have substituted transoral decompression with posterior fusion as the primary therapeutic strategy for BI and AAD [ [2] , [3] , [4] , [5] , [6] , [7] , [8] ].…”

Section: Introductionmentioning

confidence: 99%

Facet-occiput slope angle: A novel predictor of cage placement feasibility during surgery in basilar invagination patients

Alizada,

Wang,

Zhao

et al. 2023

Heliyon

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The enigma of acute worsening after a latent interval in post-operative patients of craniovertebral junction instability

Salunke

Karthigeyan

Singh

2021

Clinical Neurology and Neurosurgery

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‘Congenital anomalies of craniovertebral junction presenting after 50 years of age’: An oxymoron or An unusual variation?

Cited by 5 publications

References 17 publications

Six-year longitudinal prospective comparative study between preoperative and postoperative heart rate variability indices in congenital craniovertebral junction anomalies

Six-year longitudinal prospective comparative study between preoperative and postoperative heart rate variability indices in congenital craniovertebral junction anomalies

Facet-occiput slope angle: A novel predictor of cage placement feasibility during surgery in basilar invagination patients

The enigma of acute worsening after a latent interval in post-operative patients of craniovertebral junction instability

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