Basilar Invaginationenparents invagination is when the top of the spine pushes up into the base of the skull. It causes pinching and pressing on the brain stem.vertebrae, basilar invagination, basilar, invagination, basilar impression, neck, spine, backbone, brain, brain stem, platybasia, cervical vertebrae, C1, C7, C2, rickets, marfan, osteogenesis imperfecta, brittle bone disease, arthritis, 04/24/201904/29/201904/29/2019Suken A. Shah, MD and Alicia McCarthy, APRN04/01/201929c33524-3b40-4257-a3c8-63f069046956<h3>What Is Basilar Invagination?</h3> <p>Basilar invagination (BI) is when the top of the spine pushes into the base of the skull. This causes pinching and pressing on the brain stem, the thick bundle of nerves that connects the <a href="">brain</a> to the spinal cord.</p> <p>Basilar invagination (BA-zih-ler in-vaj-ih-NAY-shin) that is very mild is called basilar impression.</p> <h3>What Happens in Basilar Invagination?</h3> <p>The condition is caused by either an unusual flattening of the bottom of the skull (called platybasia), and/or problems with the bones in the neck.</p> <p><img class="center_this" title="Illustration shows normal brain anatomy without basilar invagination" src="" alt="Illustration shows normal brain anatomy without basilar invagination" /></p> <p>The neck is a stack of separate bones called vertebrae :</p> <ul class="kh_longline_list"> <li>The seven vertebrae in the neck are the <strong>cervical vertebrae</strong>. They're abbreviated C1–C7.</li> <li>C1 sits at the top and supports the skull.</li> <li>C2 sits below C1. It has an upright peg at the front that goes up through C1.</li> <li>C1 pivots on C2's peg so the head can turn to the right or left.</li> <li>Sometimes, that peg pushes up higher than it should, putting pressure on the brainstem.</li> </ul> <p><img class="center_this" title="Illustration shows brain anatomy with basilar invagination" src="" alt="Illustration shows brain with basilar invagination" /></p> <p></p> <h3>What Are the Signs &amp; Symptoms of Basilar Invagination?</h3> <p>Basilar invagination can cause different symptoms depending on which part of the brain stem is pinched or pressed. Common symptoms include:</p> <ul> <li><a href="">headache</a> (usually pain in the back of the head or upper neck)</li> <li>neck weakness</li> <li>confusion</li> <li>trouble talking or swallowing</li> <li>feeling dizzy or lightheaded</li> <li>numbness or tingling in the hands or feet</li> <li>loss of proprioception (knowing the position of body parts without looking)</li> <li>the feeling of a shock down the back when the neck bends forward</li> <li>weakness or paralysis of the arms, legs, or both</li> <li>trouble going to the bathroom (peeing or pooping), or having pee or poop accidents</li> </ul> <p>Symptoms can get worse when the neck bends forward.</p> <h3>What Causes Basilar Invagination?</h3> <p>A child can be born with the condition (congenital basilar invagination) or develop it over time.&nbsp;</p> <p>The cause of congenital basilar invagination isn't known. There's nothing the parents could have done to prevent it.</p> <p>BI that develops over time can happen because of:</p> <ul> <li>an injury (such as a <a href="">fall</a> or <a href="">car</a> or <a href="">bike</a> accident)</li> <li>a bone, connective tissue , immune, endocrine, or other disorder, such as: <ul> <li><a href="">osteogenesis imperfecta (brittle bone disease)</a></li> <li><a href="">Marfan syndrome</a></li> <li>rheumatoid <a href="">arthritis</a></li> <li>rickets (when bones get soft and weak)</li> </ul> </li> </ul> <h3>How Is Basilar Invagination Diagnosed?</h3> <p>Children with symptoms of BI are checked by health care providers who specialize in:</p> <ul> <li>brain and nerve problems (neurology)</li> <li>brain and nerve surgery (neurosurgery)</li> <li>bone problems (orthopedics)</li> </ul> <p>The provider will ask about symptoms and do an exam, checking muscles and nerves all over the body.</p> <p><a href="">X-rays</a> or a <a href="">computer tomography (CT) scan</a> can help them reach a diagnosis. An <a href="">MRI</a> is the best test to look at the brain stem and spinal cord.</p> <h3>How Is Basilar Invagination Treated?</h3> <p>Health care providers might just do regular checkups for a child with basilar invagination who has mild or no symptoms.</p> <p>Some symptoms can be treated with:</p> <ul> <li>anti-inflammatory medicines</li> <li>manual traction (pulling) on the neck</li> <li>a cervical (neck) collar or cervical-thoracic brace (which supports the head, neck, and upper back)</li> <li><a href="">physical therapy</a></li> </ul> <p>If symptoms include nerve problems or if the neck isn't stable, a child might need surgery. The surgeon may do an operation through the nose, the mouth, or at the back of the head and neck. Sometimes a child needs <a href="">halo-gravity traction</a> for a few weeks before surgery to help the skull and neck get into a better position.</p> <h3>What Else Should I Know?</h3> <p>As a child with BI grows, be sure to:</p> <ul class="kh_longline_list"> <li>Watch for new or worsening symptoms.</li> <li>Go to all follow-up visits as recommended by the health care provider.</li> <li>Get any imaging tests needed to check for changes to the skull and neck bones.&nbsp;</li> </ul> <p>Neck injuries in children with basilar invagination&nbsp;are more likely to be severe or fatal than in most children. So they should avoid activities that put them at risk for neck injuries, such as contact sports, diving, and gymnastics.</p>
Brain and Nervous SystemThe brain controls everything we do, and is often likened to the central computer within a vast, complicated communication network, working at lightning speed.
Chiari I MalformationMany kids with this brain condition aren't bothered by it. Those who have symptoms can often find relief with medicines or surgery.
Halo-Gravity TractionHalo-gravity traction is a way to pull the head and spine upward. Doctors use it to treat curvature of the spine and to prepare kids for spinal fusion surgery.
Marfan SyndromeMarfan syndrome affects the body's connective tissue and can cause problems in the eyes, joints, and heart. Even though the disease has no cure, doctors can successfully treat just about all of its symptoms.
Osteogenesis Imperfecta (Brittle Bone Disease)Osteogenesis imperfecta (or brittle bone disease) prevents the body from building strong bones. People with OI have bones that might break easily.
Physical TherapyDoctors often recommend physical therapy for kids who have been injured or have movement problems from an illness, disease, or disability. Learn more about PT.
ScoliosisScoliosis makes a person’s spine curve from side to side. Large curves can cause health problems like pain or breathing trouble. Health care providers treat scoliosis with back braces or surgery when needed.
Spinal Fusion SurgeryA spinal fusion is a surgical procedure that's done to stabilize or straighten the bones in the back. It can help kids and teens with scoliosis.
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