Clinical Syndromes Associated With Basilar Impression

Ten patients with basilar impression are described in this communication. They were all seen in the Neurosurgical Department in the course of one year. They are described because they include not only examples of common clinical syndromes—syringomyelia, spinal cord compression, cerebellar compression, and obstruction of the fourth ventricle— but also two syndromes not previously described: (1) intermittent attacks of altered consciousness and confusion; (2) hemiparetic attacks with recovery, apparently caused by cerebral vascular insufficiency in young patients. The patients will be described individually in summary, including only the positive neurological findings and the related pathology defined at operation. The etiology of the two unusual syndromes will be considered. X-Ray Diagnosis Since the diagnosis of basilar impression prior to operation is necessarily a radiological one, the criteria adopted by us are described. Many lines and angles have been proposed and objections later raised to most of them. The lines of Chamberlain