Basilar Invagination

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Basilar Invagination

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Published: Sept. 29, 2010
Updated: Nov. 17, 2010

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basilarinvag.jpgBasilar invagination, also known as cranial settling, is a rare condition in which the second vertebrae in the neck, known as the dens or odontoid process, pushes upward and puts pressure on the brain stem or spinal cord, causing various neurological symptoms.

What causes basilar invagination?

This condition may be present at birth or develop as a result of disease or injury.

What does it feel like?

Symptoms include dizziness, headache, tingling, or numbness in upper extremities, pain in the neck when it is bent, and difficulty swallowing. Symptoms typically depend on the amount of pressure on the brain stem and spinal cord.

How do I know if I have basilar invagination?

Your physician will order a magnetic resonance imaging (MRI) or computed tomography (CT) scan. A physical examination is also necessary to determine the extent of your clinical signs and symptoms.

How is basilar invagination treated?

Surgery is typically the treatment of choice for this condition. Cervical traction may be used to alleviate compression of the brain stem and spinal cord. In cases of severe compression, direct removal of the dens may be necessary.

The specialists at the Duke Spine Center are experts in a number of techniques to treat basilar invagination.


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My MRI’s state that I have mild basilar invagination but my NL doesn’t mention anything about it. There are other neurological terms used that have never been discussed with me. I don’t have the headaches when straining anymore but will get pressure or tension headaches once or twice a week. I have swallowing issues and tingling in my feet sometimes and get twitches or restless leg. I also developed POTs. Oh ya, just feel lethargic sometimes and cognitive issues. I think that’s it. But I’m glad I went through with surgery. I actually had no choice as I was developing hydrocephalus. I always wonder if there’s anything else a NS can help me with or when is it time to go searching again for answers. I just deal with these symptoms hoping it doesn’t get worse and/or having to have surgery again. I really wish there was one doctor that could treat all my issues and not have to go to 10 different specialists. Thanks for posting this.

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Thanks Abby for your reply. I am making a medical file with all reports, cd's and doctors records so that I can see with my own eyes what my brain is going through. Its also a proactive approach for when or if I ever need surgery again I can take it to the doctors for second opinions.

I will ask my NL next time I see him about EDS and doing more tests.

I wonder if basilar invagination can get worse or if anything can make it worse. Right now mine is mild.

My TMJ is also messed up right now. I just got an MRI of the joint yesterday and will see what's going on there.

Thanks again.