{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T19:04:29Z","timestamp":1767726269093,"version":"3.48.0"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>The skull base exhibits numerous morphologic variants, some of which are uncommon and hold clinical significance. The imaging report presents a rare instance of multiple skull base variants identified incidentally through a computed tomography (CT) scan of a 53-year-old female patient. The findings revealed a bilateral partial atlanto-occipital fusion (AOF), an absent C1 posterior arch, and a complete bilateral ossification of the caroticoclinoid and anterior interclinoid ligaments in the form of bars (CCBs and AIBs). This distinctive combination of variants has not been emphasized in existing literature. Recognizing these morphologic variants is essential for preoperative planning to mitigate the risk of neurovascular injury during skull base procedures. This case underscores the necessity of comprehensive anatomic assessment via CT imaging to detect intricate skull base alterations. Acknowledging these rare coexisting congenital abnormalities is crucial for enhancing patient outcomes within clinical and surgical frameworks.<\/jats:p>","DOI":"10.1097\/scs.0000000000011908","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T15:00:14Z","timestamp":1756825214000},"page":"e1310-e1312","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Atlanto-Occipital Fusion With Complete Absent Atlas Posterior Arch and Complete Ossified Caroticoclinoid and Anterior Interclinoid Ligaments"],"prefix":"10.1097","volume":"36","author":[{"given":"Panagiotis","family":"Papadopoulos-Manolarakis","sequence":"first","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece"},{"name":"Department of Neurosurgery, General Hospital of Nikaia-Piraeus, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0122-2436","authenticated-orcid":false,"given":"George","family":"Triantafyllou","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandros","family":"Samolis","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Paschopoulos","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Piagkou","sequence":"additional","affiliation":[{"name":"Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"R1-20260106","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1007\/s00276-023-03226-4","article-title":"A morphological study on the sphenoid bone ligaments\u2019 ossification pattern","volume":"45","author":"Piagkou","year":"2023","journal-title":"Surg Radiol Anat"},{"key":"R2-20260106","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s00276-024-03563-y","article-title":"The posterior petroclinoid fold and petroclival ligament ossification patterns","volume":"47","author":"Triantafyllou","year":"2025","journal-title":"Surg Radiol Anat"},{"key":"R4-20260106","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s00276-016-1687-9","article-title":"A morphometric study of the atlas occipitalization and coexisted congenital anomalies of the vertebrae and posterior cranial fossa with neurological importance","volume":"39","author":"Natsis","year":"2017","journal-title":"Surg Radiol Anat"},{"key":"R5-20260106","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.jcms.2018.01.008","article-title":"Incidence and morphometry of sellar bridges and related foramina in dry skulls: Their significance in middle cranial fossa surgery","volume":"46","author":"Natsis","year":"2018","journal-title":"J Craniomaxillofac Surg"},{"key":"R6-20260106","doi-asserted-by":"crossref","first-page":"390","DOI":"10.3171\/2018.9.PEDS18481","article-title":"The caroticoclinoid foramen in fetal and infantile orbitosphenoid, presphenoid, and sphenoid bones: developmental and neurosurgical considerations","volume":"23","author":"Zdilla","year":"2019","journal-title":"J Neurosurg Pediatr"},{"key":"R7-20260106","first-page":"100349","article-title":"Prevalence of occipitalisation in a South African Black population: an original study of 1119 skulls with a review of the literature","volume":"37","author":"Boekkooi","year":"2024","journal-title":"Transl Res Anat"},{"key":"R8-20260106","doi-asserted-by":"crossref","first-page":"468","DOI":"10.5115\/acb.23.281","article-title":"Atlantooccipital assimilation associated with combined atlas arch defect: a radiological case report","volume":"57","author":"Suwannakhan","year":"2024","journal-title":"Anat Cell Biol"},{"key":"R9-20260106","doi-asserted-by":"crossref","first-page":"975","DOI":"10.31616\/asj.2023.0030","article-title":"Radiological study of atlas arch defects with meta-analysis and a proposed new classification","volume":"17","author":"Suphamungmee","year":"2023","journal-title":"Asian Spine J"},{"key":"R10-20260106","doi-asserted-by":"crossref","first-page":"440","DOI":"10.3390\/diagnostics15040440","article-title":"Prevalence and morphology of ossified caroticoclinoid ligament: an updated systematic review with meta-analysis","volume":"15","author":"Triantafyllou","year":"2025","journal-title":"Diagnostics"},{"key":"R11-20260106","doi-asserted-by":"crossref","first-page":"76","DOI":"10.3390\/diagnostics15010076","article-title":"The morphological stenosis pattern of the caroticoclinoid foramen","volume":"15","author":"Paschopoulos","year":"2024","journal-title":"Diagnostics"}],"container-title":["Journal of Craniofacial Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/SCS.0000000000011908","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T19:00:26Z","timestamp":1767726026000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/SCS.0000000000011908"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":10,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1097\/scs.0000000000011908","relation":{},"ISSN":["1049-2275","1536-3732"],"issn-type":[{"type":"print","value":"1049-2275"},{"type":"electronic","value":"1536-3732"}],"subject":[],"published":{"date-parts":[[2025,9,1]]},"assertion":[{"value":"2025-07-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-09","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}