Abstract
Background:
Deposition of CPPD crystals occurs in the fibrous and hyaline cartilage of the joints and intervertebral disks of the spine. Half of patients known to have chondrocalcinosis had asymptomatic calcification in the odontoid region. The cases of 12 patients with a spinal cord syndrome secondary to CPPD deposition in the odontoid region were published in the literature. In all those cases, the mass lesion was extradural in location with good outcome after surgical decompression via the transoral route.
Case description:
We report on a rare case of large periodontoid CPPD deposition causing cervicomedullary compression, erosion of the overlying bone, and underlying dura with intradural extension and vertebral artery encasement.
Conclusions:
Calcium pyrophosphate dihydrate is a rare cause of cervicomedullary compression. Intradural extension of periodontoid CPPD has not been reported on.
MeSH terms
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Atlanto-Axial Joint / diagnostic imaging
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Atlanto-Axial Joint / pathology
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Atlanto-Axial Joint / physiopathology*
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Chondrocalcinosis / complications
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Chondrocalcinosis / pathology
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Chondrocalcinosis / physiopathology*
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Cranial Fossa, Posterior / pathology
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Cranial Fossa, Posterior / physiopathology
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Decompression, Surgical
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Dura Mater / pathology
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Dura Mater / physiopathology
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Fatal Outcome
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Foramen Magnum / diagnostic imaging
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Foramen Magnum / pathology
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Foramen Magnum / physiopathology
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Humans
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Magnetic Resonance Imaging
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Male
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Medulla Oblongata / blood supply
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Medulla Oblongata / pathology
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Medulla Oblongata / physiopathology*
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Middle Aged
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Neurosurgical Procedures
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Spinal Cord Compression / etiology
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Spinal Cord Compression / pathology
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Spinal Cord Compression / physiopathology*
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Spondylarthritis / complications
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Spondylarthritis / pathology
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Spondylarthritis / physiopathology*
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Tomography, X-Ray Computed
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Vertebrobasilar Insufficiency / etiology
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Vertebrobasilar Insufficiency / pathology
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Vertebrobasilar Insufficiency / physiopathology*