A case of occipitalization of the atlas is reported. It is a congenital abnormality of the cervical spine characterized by partial or total fusion of the atlas with the occipital. In 50% of cases this lesions are associated with basilar impression and neurological symptoms determine. It is important to if this anomaly is present even in the presence of common symptoms like cervical pain and vertigo. Surgery is the treatment of choice if the inestability exist consistingin posterior occipital-axis arthrodesis with transoral resection of the odontoid process if severe neurological symptoms are present.

A case of occipitalization of the atlas is reported. It is a congenital abnormality of the cervical spine characterized by partial or total fusion of the atlas with the occipital. In 50% of cases this lesions are associated with basilar impression and neurological symptoms determine. It is important to if this anomaly is present even in the presence of common symptoms like cervical pain and vertigo. Surgery is the treatment of choice if the inestability exist consistingin posterior occipital-axis arthrodesis with transoral resection of the odontoid process if severe neurological symptoms are present.