CLINICAL FEATURES, DIAGNOSTIC APPROACHES, AND CONSERVATIVE TREATMENT OF KIMMERLE ANOMALY IN NEUROLOGICAL PRACTICE

Abstract

Abstract. Kimmerle anomaly (KA) is one of the most common osseous anomalies of the craniovertebral  junction  and  may  lead  to  vertebrobasilar  insufficiency  and  neurovascular complications. The aim of this study was to analyze the incidence of KA in a neurological hospital, to identify the main clinical syndromes, and to substantiate rational conservative treatment approaches. The study included a screening examination of 8,436 patients hospitalized in a neurological clinic over a six-year period, using clinical neurological assessment, radiography, CT, MRI, and ultrasound of cerebral and cervical vessels. KA was identified in 68 patients aged 18–67 years. Three major clinical syndromes were distinguished: pain syndrome, vascular insufficiency  syndrome, and autonomic dysfunction syndrome, as well as three degrees of disease severity. Conservative therapy consisting of non-steroidal anti-inflammatory drugs, muscle relaxants, vitamin complexes, physical therapy, and massage proved effective in symptom control and achievement of long-term remission. The findings support the effectiveness of pathogenetically oriented conservative management of KA, particularly in early and moderate stages of the disease.