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Arcuate foramen

In human anatomy, arcuate foramen, also known as ponticulus posticus (Latin for "little posterior bridge") or Kimmerle's anomaly,[1] refers to a bony bridge on the atlas (C1 vertebra) that covers the groove for the vertebral artery. It is a common anatomical variation and estimated to occur in approximately 3-15% of the population.[2][3][4] It occurs in females more commonly than males.[3][5] The ponticulus posticus is created through ossification of the posterior atlantooccipital ligament.


The presence of arcuate foramen is associated with headache, musculoskeletal pain[3] and vertebrobasilar stroke.[2]


  1. ^ Koutsouraki E, Avdelidi E, Michmizos D, Kapsali SE, Costa V, Baloyannis S (2010). "Kimmerle's anomaly as a possible causative factor of chronic tension-type headaches and neurosensory hearing loss: case report and literature review". Int. J. Neurosci. 120 (3): 236–9. doi:10.3109/00207451003597193. PMID 20374094.
  2. ^ a b Cushing K, Ramesh V, Gardner-Medwin D, Todd N, Gholkar A, Baxter P, Griffiths P (2001). "Tethering of the vertebral artery in the congenital arcuate foramen of the atlas vertebra: a possible cause of vertebral artery dissection in children". Dev Med Child Neurol. 43 (7): 491–6. doi:10.1017/S0012162201000901. PMID 11463182. Full Text.
  3. ^ a b c Cakmak O, Gurdal E, Ekinci G, Yildiz E, Cavdar S (2005). "Arcuate foramen and its clinical significance". Saudi Med J. 26 (9): 1409–13. PMID 16155658.
  4. ^ Young J, Young P, Ackermann M, Anderson P, Riew K (2005). "The ponticulus posticus: implications for screw insertion into the first cervical lateral mass". J Bone Joint Surg Am. 87 (11): 2495–8. doi:10.2106/JBJS.E.00184. PMID 16264126.
  5. ^ Stubbs D (1992). "The arcuate foramen. Variability in distribution related to race and sex". Spine. 17 (12): 1502–4. doi:10.1097/00007632-199212000-00010. PMID 1471009.

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