Affiliation:
1. Privolzhsky District Medical Center FMBA
2. City Clinical Hospital No. 39
3. Lobachevsky State University of Nizhny Novgorod
4. Far Eastern District Medical Center
Abstract
The Kimmerle anomaly is one of the varieties of craniovertebral junction anomalies. Currently, it is one of the main causes of vertebrobasilar insufficiency, vertebral pain and vegetative syndromes. Despite a sufficient number of publications on this problem, the Kimmerle anomaly still remains not fully understood. Insufficient awareness of primary care physicians about this pathology, a wide variety of clinical manifestations, the absence of pathognomonic neurological syndromes, the complexity of the analysis of imaging data cause difficulties in identifying this anomaly. The article describes the epidemiology, pathogenesis, and clinical picture of Kimmerle anomaly. Further, the paper presents modern methods of its diagnosis (spondylography, ultrasound, MRI, MSCT, etc.) and treatment. In conclusion, the authors present ways to optimize the diagnosis and treatment of Kimmerle anomaly.
Publisher
FSBEI of Higher Education SamSMU of Ministry of Health of the Russian Federation
Reference48 articles.
1. Gulyaev SA, Kulagin VN, Arkhipenko IV, et al. Clinical manifestations of anomalies of the craniovertebral region according to the Kimmerle variant and features of their treatment. Russian Medical Journal. 2013;21(16):866-868. (In Russ.). [Гуляев С.А., Кулагин В.Н., Архипенко И.В., и др. Клинические проявления аномалии краниовертебральной области по варианту Киммерле и особенности их лечения. Российский медицинский журнал. 2013;21(16):866-868].
2. Krylov VV, Lukyanchikov VA, Lvov IS, et al. Surgical treatment of vertebrovascular conflict in patients with Kimmerle anomaly. Russian neurosurgical journal named after Professor A.L. Polenov. 2017;9(2):16-21. (In Russ.). [Крылов В.В., Лукьянчиков В.А., Львов И.С., и др. Хирургическое лечение вертеброваскулярного конфликта у пациентов с аномалией Киммерле. Российский нейрохирургический журнал им. профессора А.Л. Поленова. 2017;9(2):16-21].
3. Split W, Sawrasewicz-Rybak M. Character of headache in Kimmerle anomaly. Headache. 2002;9:911-916. https://doi.org/10.1046/j.1526-4610.2002.02213.x
4. Lutsik AA, Peganov AI, Kazantsev VV, et al. Vertebrobasilar insufficiency caused by bone anomalies of the craniovertebral junction. Spinal Surgery. 2016;13(4):49-55. (In Russ.). [Луцик А.А., Пеганов А.И., Казанцев В.В., и др. Вертебробазилярная недостаточность, обусловленная костными аномалиями краниовертебрального перехода. Хирургия позвоночника. 2016;13(4):49-55].
5. Elliott RE, Tanweer O. The prevalence of the ponticulus posticus (arcuate foramen) and its importance in the Goel-Harms procedure: meta-analysis and review of the literature. World Neurosurg. 2014;82(1-2):335-343.