Craniocervical Syndromes, EDS and MS

Image by Reigh LeBlanc via Flickr

There are many different types of inherited and acquired disorders, as well as degenerative conditions (aging and wear and tear) of the cervical spine, especially the upper cervical spine (skull and upper cervical spine). I refer to them as craniocervical syndromes in my book.  Craniocervical syndromes can cause and array of neurological signs and symptoms related to the brain and cord.

Craniocervical syndromes cause problems by compressing blood and cerebrospinal fluid pathways going into and out of the brain and cord. They can also cause compressive myelopathy of the cervicomedullary cord; which is compression of the lower brainstem and upper cord. Craniocervical syndromes can thus cause an array of signs and symptoms.

In the brain scan above the cauliflower looking structure, at the lower rear part of the brain, is the cerebellum. In front of and below the cerebellum is a verticle tube-like structure which is the brainstem and cord. At the top of the tube-like structure is a round protruding belly-like part of the brainstem in front of the cerebellum called the pons. Above the pons is the midbrain of the brainstem and below it is the medulla oblongata which is the lowest part of the brainstem that connects to the highest part of the spinal cord. Pons is the Latin word for bridge. The pons was called a bridge because it links the midbrain, cerebellum and medulla of the brainstem together.

In front of the pons and behind a black circular structure (the sphenoid sinus) is a white triangular shaped structure with what could be described as a white cup at the very top.  The structure is the clivus of the base of the skull. The cup is the compartment in the skull that contains the pituitary gland, which is the master gland that controls the endocrine system. The very bottom of the clivus is the front side of the foramen magnum. This is a large opening in the base of the skull to accommodate the brainstem and cord. Across from it and under the cerebellum (cauliflower) is a thin white strip which is part of the occipital bone that forms the rear of the foramen magnum.

Just below the bottom of the clivus on the front side of the foramen magnum is a white peg-like structure with a black line shaped like a cap over it. The peg-like structure is the dens or odontoid part of the second cervical vertebra below the skull. The dens sits in a pocket of the atlas or first cervical vertebra. The dens is a pivot joint for left and right rotation of the neck. The black line, in front and back of the dens, is fluid that lubricates the joint. A ligament holds the dens in place inside the atlas formed pocket and keeps it from moving posteriorly (back) causing it to compress the spinal cord.

The cerebellum sits in its own compartment called the posterior fossa.  The dark shadow above the cerebellum is the tent-like covering over the posterior fossa called the tentorium cerebelli. The covering is not flat but angles upward. There is a whole in the covering called the incisura for the brainstem to pass through to the foramen magnum and cord below. In the graphic picture on the left, the green area is the right half of the tentorium cerebelli that covers the cerebellum in the posterior fossa below. It divides the brain into upper and lower comparments. The light red area represents the falx cerebri, which is a vertical curtain of connective tissue similar to the tentorium that divides the brain into left and right halves. A similar vertical curtain of connective tissue, called the falx cerebelli, also separtes the posterior fossa and cerebellum into left and right sides.

The posterior fossa and upper cervical spine are critical to blood and CSF flow and contain some of the most crucial components of the brain and cord. Many conditions affect the upper cervical spine and base of the skull predisposing humans to neurodegenerative conditions and subsequent diseases. This is due to the unique design of the skull, spine and circulatory system of the brain and cord as a result of upright posture.

One genetic condition in particular underscores the role of craniocervical syndromes in neurodegenerative conditions due to it’s design flaws.  That condition is Ehlers-Danlos syndrome or EDS. Even the short version of EDS is far too long to discuss here but is discussed on my website. In brief, certain cases of Ehlers-Danlos Syndrome (EDS) affect the design of the skull and some affect the upper cervical spine resulting in Chiari malformations and hydrocephalus type condtions among other things.

I will discuss other craniocervical syndromes that can cause similar problems as the website develops. The design of the base of the skull and upper cervical spine needs to be studied much further. It may be a key culprit in many neurodegenerative conditions. Upright MRI will shed much more light on this in the future.

For additional information on this and other related topics as well as my book go to my website at www.upright-health.com.