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Case Reports
. 2014 Sep;27(4):495-7.
doi: 10.15274/NRJ-2014-10056. Epub 2014 Aug 29.

Crowned dens syndrome. A case report

Anna Koyfman  1 , Daniel Yaffe  2
Affiliations
Case Reports

Crowned dens syndrome. A case report

Anna Koyfman et al. Neuroradiol J. 2014 Sep.

Abstract

Crystal deposition in the cervical spine around the odontoid process may lead to acute neck pain. This rare condition is called crowned dens syndrome and should be considered in the differential diagnosis of a possible etiology for fever, headache and cervical pain of unknown origin. The syndrome is often overlooked, thus leading to misdiagnosis, invasive and useless investigations (lumbar puncture, biopsy), inappropriate treatment (steroids, antibiotics, antiviral drugs) and prolonged hospitalization. This can be prevented by imaging, based on a cervical CT scan that allows an accurate diagnosis. The disease has a good prognosis and symptoms usually subside within a few weeks. We describe a patient with crowned dens syndrome which manifested with clinical (acute occipital headache) and radiographic (calcium deposits in the alar ligament) features. Our patient recovered in four days with symptomatic therapy.

Keywords: acute headache; alar ligament; calcium deposits; crowned dens syndrome.

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Figures

Figure 1
Figure 1
Axial CT image of the brain at level C1-2 shows calcium deposits around the right side of the odontoid process in the alar ligament.
See this image and copyright information in PMC

References

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