Basilar Invagination

Basilar invagination is a rare, sometimes fatal condition that occurs when the body’s second vertebrae moves upward, pressing on the lower part of the brain. In some cases, this can block the opening where the spinal cord passes through the skull. Basilar invagination can be present at birth, or caused by an accident or bone disease, such as rheumatoid arthritis.



Symptoms of basilar invagination may include:

  • Confusion
  • Numbness or tingling in arms or legs
  • Paralysis
  • Swallowing problems


To diagnose basilar invagination, your doctor will begin with a physical exam. You’ll talk about your symptoms, and your doctor may order imaging tests, such as an MRI, CT scan or X-ray.

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Treatment Options

Dr. Amin Kassam, Aurora’s Vice President of Neurosciences, explains the Expanded Endonasal Approach.

If you have basilar invagination, your Aurora neurological team will work with you to determine the best treatment options. We are home to the Aurora Neuroscience Innovation Institute (ANII), which brings together dedicated neurosurgeons and advanced technology to offer you the latest surgical and non-surgical treatment options.

If the spinal cord is not being compressed, treatments may include:

  • A cervical collar
  • Non-steroidal anti-inflammatory medication (NSAIDs), like aspirin or ibuprofen
  • Physical therapy

If surgery is required, treatment may include:

  • The Expanded Endonasal Approach (EEA), a minimally invasive procedure in which the brain is accessed through the nasal passages, resulting in no incisions, a shorter hospital stay and faster recovery than with traditional brain surgery.
  • Posterior craniocervical fusion, in which a doctor adjusts how the spine and skull join together in order to prevent the condition from reoccurring.

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