Neoplastic conditions of the craniocervical region are uncommon. Primary tumors arising at the craniocervical junction include meningiomas, neurinomas, and chordomas. Metastatic disease is exceedingly uncommon at the craniocervical junction, but may involve the atlantoaxial region. The clinical presentation of primary tumors of the craniocervical region is generally that of slowly progressive neurologic dysfunction. The clinical characteristics of metastatic disease of the atlantoaxial region are markedly different from those of metastatic disease of the subaxial cervical spine because of differences in regional anatomy and biomechanics. Metastatic lesions of C1 and C2 most frequently present with severe pain and only rarely with neurologic involvement. Optimal treatment is dependent on the tumor location and pathology. Primary tumors often require surgical resection, although complete resection is difficult because of the location and intimate involvement of adjacent structures. Goals of treatment for patients with atlantoaxial metastatic disease are stabilization of the spine, prevention of neurologic deterioration, maintenance of mobility, and amelioration of pain.
ASJC Scopus subject areas
- Clinical Neurology