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Learning from errors
Recurrent attacks of headache and neck pain caused by congenital aplasia of the posterior arch of atlas in an adult


A 47-year-old Chinese woman, with a history of recurrent attacks of vertigo and vomiting for the past 5 years, presented with intermittent radicular pain in the left upper limb for the past 2 years. She also reported recurrent attacks of severe headache and neck pain for more than 10 years. The pain might be aggravated by coughing or sneezing and relieved after sleeping in the decubitus position. The MRI depicted Chiari malformation. A multidetector CT scan and three-dimensional CT reconstruction revealed partial aplasia of the left posterior arch of atlas of a small gap. The patient underwent plastic surgeries in Beijing. The disappearance of the recurrent pain syndrome was confirmed by follow-up after surgery.

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