The pharyngovertebral veins: an anatomical rationale for Grisel's syndrome

J Bone Joint Surg Am. 1984 Apr;66(4):568-74.

Abstract

Non-traumatic subluxation of the atlanto-axial joint following peripharyngeal inflammation (Grisel's syndrome) has been attributed to laxity of the transverse ligament caused by hyperemia, but a satisfactory anatomical rationale for the association of these conditions has been lacking. Injection of the cervical epidural sinuses of a series of human perinatal cadavera showed retrograde filling of a previously undescribed system of veins with frequent lymphovenous anastomoses. This system appears to drain the posterosuperior pharyngeal region.

Clinical relevance: Because of their direct connection with the periodontoidal venous plexus and the suboccipital epidural sinuses, the pharyngovertebral veins may provide a hematogenous route for the transport of peripharyngeal septic exudates and neoplastic cells to the upper cervical spinal structures and provide an anatomical explanation for the atlanto-axial hyperemia of Grisel's syndrome.

MeSH terms

  • Adult
  • Atlanto-Axial Joint*
  • Female
  • Fetus / anatomy & histology
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Joint Dislocations / etiology*
  • Pharynx / blood supply*
  • Pregnancy
  • Syndrome
  • Veins*