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Unusual association of diseases/symptoms
Thalamic syndrome as the heralding manifestation of atlantoaxial dislocation
  1. Rajesh Verma1,
  2. Ritesh Sahu1,
  3. B K Ojha2,
  4. Vivek Junewar1
  1. 1Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
  2. 2Department of Neurosurgery, King George Medical University, Lucknow, Uttar Pradesh, India
  1. Correspondence to Professor Rajesh Verma, drrajeshverma32{at}


In India, Atlantoaxial dislocation (AAD) is the commonest skeletal craniovertebral junction (CVJ) anomaly, followed by occipitalisation of atlas and basilar invagination. The usual presentation is progressive neurological deficit (76–95% cases) involving the high cervical cord, lower brainstem and cranial nerves. The association between vertebro-basilar insufficiency and skeletal CVJ anomalies is well recognised and angiographic abnormalities of the vertebrobasilar arteries and their branches have been reported; however, initial presentation of CVJ anomaly as thalamic syndrome due to posterior circulation stroke is extremely rare. Here, we report one such rare case of thalamic syndrome as the initial presentation of CVJ anomaly with AAD.

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