Presentation
Pain in left neck with weakness left shoulder.
Patient Data
Age: 70 years
Gender: Male
From the case:
Ponticulus posticus
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Normal alignment of the cervical vertebrae noted.
Severe degenerative changes at C5/C6 with large anterior marginal osteophyte.
Less marked degenerative changes at C4/C5 and C3/C4.
Complete Ponticulus posticus of C1.
Case Discussion
Ponticulus posticus is an important anatomical variant to be aware of and has been associated with a number of clinical symptoms including 1,2;
- vertigo
- migraine
- headache
- neck pain
- retro-orbital pain
- hearing loss shoulder / arm pain
These symptoms are thought to occur secondary to decreased vertebral artery blood flow.
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