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Pseudogout of the Transverse Atlantal Ligament: An Unusual Cause of Cervical Myelopathy

Published online by Cambridge University Press:  16 February 2016

Donald E.G. Griesdale Jr. ,
Mike Boyd  and
Ramesh L. Sahjpaul
Donald E.G. Griesdale Jr.
Affiliation:
Division of Neurosurgery, Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, University of British Columbia, Vancouver BCCanada
Mike Boyd
Affiliation:
Division of Neurosurgery, Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, University of British Columbia, Vancouver BCCanada
Ramesh L. Sahjpaul*
Affiliation:
Division of Neurosurgery, Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, University of British Columbia, Vancouver BCCanada
*
3878 W 18th Ave, Vancouver BC V6S 1B5, Canada.
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Abstract

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Background:

Calcium pyrophosphate dihydrate deposition in the cervical spine is infrequently symptomatic. This is especially true at the craniocervical junction and upper cervical spine.

Case Report:

A 70-year-old previously healthy woman presented with a progressive cervical myelopathy of four months duration.

Results:

Examination revealed sensorimotor findings consistent with an upper cervical myelopathy. Radiological studies (plain radiographs, computed tomography, and magnetic resonance imaging) revealed C1-2 instability, and a well-defined extradural 3cm x 1cm retro-odontoid mass causing spinal cord compression. Transoral resection of the mass was performed followed by posterior C1-2 stabilization. Histological examination of the mass confirmed calcium pyrophosphate dihydrate deposition. Follow-up examination showed marked clinical and radiological improvement.

Conclusion:

Although uncommon, calcium pyrophosphate dihydrate deposition disease should be considered in the differential diagnosis of extradural mass lesions in the region of the odontoid.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 2 , May 2004 , pp. 273 - 275
Copyright
Copyright © The Canadian Journal of Neurological 2004

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