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Case Reports
. 2017 Aug;33(8):1415-1417.
doi: 10.1007/s00381-017-3459-1. Epub 2017 Jul 6.

Radiological evolution of peri-odontoid pannus in a patient with Chiari I malformation: a case-based review

Felipe Hada Sanders  1 , Joy M H Wang  2 , Rod J Oskouian  3 , R Shane Tubbs  3 , W Jerry Oakes  4
Affiliations
Case Reports

Radiological evolution of peri-odontoid pannus in a patient with Chiari I malformation: a case-based review

Felipe Hada Sanders et al. Childs Nerv Syst. 2017 Aug.

Abstract

Introduction: The Chiari I malformation (CIM) is commonly encountered by neurosurgeons and can have different etiologies and clinical presentations.

Case report: We report a CIM patient who presented with symptoms of ventral brain stem compression and was found to have a large peri-odontoid pannus. Posterior fossa decompression was performed with a planned second-stage odontoidectomy. However, at the 6-month follow-up, postoperative images demonstrated a mostly resolved pannus and improvement of the brain stem compression symptoms, and the patient progressed uneventfully without the need for odontoidectomy.

Conclusions: This case illustrates the resolution of a significant and symptomatic peri-odontoid pannus in a patient with CIM without craniocervical fusion or odontoidectomy. Such a case indicates that not all peri-odontoid pannus formations in CIM patients are due to hypermobility at the craniocervical junction.

Keywords: Brain stem; Craniocervical fusion; Dens; Neurosurgery; Pediatrics; Ventral compression.

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