Hidden at the Craniovertebral Junction: Atlantoaxial Instability with Cervicomedullary Compression in a Child with Multiple Congenital Anomalies

Authors

Mehdi Salmane, Alia Yassine Kassab, Lina Lasri, Lina Belkouchi, Siham El Haddad, Nazik Allali, Latifa Chat

Journal Information

Journal: Medpeer Publisher

ISSN: 3066-2737

Volume: 3

Issue: 6

Date of Publication: 2026/06/04

DOI: 10.70780/medpeer.000QGT9

Abstract

Atlantoaxial instability is an uncommon but potentially life-threatening condition in children, particularly when associated with congenital or syndromic disorders. We report the case of a 9-year-old child presenting with orthopedic malformations, encopresis, and facial dysmorphism. Cervical spine MRI revealed C1–C2 dislocation with marked widening of the atlantodental interval, associated with hypertrophic soft tissue surrounding the odontoid process causing narrowing of the foramen magnum and compression of the cervicomedullary junction. Associated T2 hyperintensity within the spinal cord suggested chronic myelopathic changes. This case highlights the importance of imaging evaluation of the craniovertebral junction in children with complex congenital abnormalities and neurological manifestations.

Keywords

Atlantoaxial instability, C1–C2 dislocation, Craniovertebral junction, Pediatric myelopathy, Cervicomedullary compression.