Hypertrophic Posterior Arch of Atlas Causing Cervical Myelopathy

Cervical stenosis, especially of the upper cervical spine, is quite rare which can be developmental or acquired. Clefts or aplasias of anterior and posterior arches of atlas, ossification of the transverse atlantal ligament, hypertrophy of the dens and os odontoideum are rare conditions causing cervical myelopathy reported either singly or in combination. Hypertrophy of the posterior arch of atlas in the absence of any ring hypoplasia as a cause of cervical myelopathy has not been reported earlier. The authors report a case of cervical myelopathy in a 26-year-old female due to hypertrophied posterior arch of atlas which was preoperatively diagnosed as a bony tumor. Being aware of such an entity may avoid diagnostic surprises and facilitate patient prognostication and management.

Asymptomatic posterior fossa subdural effusion

Though subdural effusion is very common supratentorially; a similar occurrence in the posterior fossa is rather unusual with all the cases of posterior fossa subdural collection reported in the literature being symptomatic, mandating some form of intervention. An asymptomatic posterior fossa collection is not reported before as per the authors' review of the literature. The authors report a 5-year-old child was found to have a posterior fossa subdural collection postoperatively after a posterior fossa surgery. As the child was asymptomatic, the parents were reassured and the child was managed conservatively. Posterior fossa subdural effusion is very rare condition mandating some form of surgical intervention. It can occasionally be asymptomatic, in which case a conservative approach can be followed. A regular follow-up is recommended to detect any neurological deterioration, however