Рентгенология & Радиология, 2010, XLІХ 196-199

Cranial Paget’s disease – clinical case of symptomatic secondary basilar impression
Е. Gagov, N. Gabrovsky, St. Gabrovsky
Department of Diagnostic Imaging, Emergency Hospital “N. I. Pirogov” – Sofia


A clinical case of 52 years old woman with history of periodic headaches for many years. The headache became more intensive and constant during the last 4-6 months. Instability by walking and stagger occurred as well as weakness in all 4 extremities, difficult swallowing and speech changes. Bulbar, quadripyramidal and archicerebellar symptoms were in hand. Paget’s disease was ascertained engaging the skull with secondary basilar impression and compression of the cerebellum and the brain-stem leading to the above described clinical signs. Decompressive median suboccipital craniectomy was performed with laminectomy of C1. Occipital squama was thickened and highly vascularized. Secondary basilar impression could occur in cranial Paget’s disease with clinical symptoms resulting from the compression of the cerebellum and the brain-stem.

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