Imaging to Rule out Craniocervical Instability
While not imaging or report is perfect, the best imaging to rule out craniocervical instability is as follows:
Dynamic upright MRI Cervical Spine and Craniocervical Junction in neutral, flexion – extension positions as well as Dynamic CBCT Cervical Spine and Craniocervical Junction in neutral, flexion, extension, lateral side bending left and right and rotation left and right. The MRI allows the physicians to view soft tissues and the spinal cord, whereas the CBCT allows for better view and measurements of the bones.
If these are not available to you, the next best imaging to rule out craniocervical instability is as follows:
Supine MRI Brain and Craniocervical Junction AND Supine MRI Cervical Spine and Craniocervical Junction.
Other differential diagnosis could be related to cerebrospinal fluid or blood flow issues which can be investigated via MR Angiogram and MR Venogram, Dopplar Catheter Scan and CSF Flow Study.
More coming soon!