J. small Anim . Pract. (1979) 20, 501 - 508.

;_

A study of the radiographic anatomy of the

foramen magnum in dogs
JAYNE A. WRIGHT
Department of Surgery and Obstetrics, Royal Veterinary College Field Station, Hawkeshead Lane,
North Mimms, Hatfield, Herts

ABSTRACT
The shape and size of the foramen magnum were investigated in a number
of breeds. It was found that dorsal extension occurred in toy breeds, both
with and without neurological symptoms. An increase in the size of the
foramen magnum was not necessarily associated with a pathological
process.

INTRODUCTION
Congenital malformation of the foramen magnum has been reported in some
small breeds of dog (Hoerlein , 1971; Morgan, 1972; Parker & Park, 1974; Kelly,
1975). The clinical signs that have been attributed to this condition include
occipito-cervical pain, dysphagia, ataxia and convulsions (Parker & Park, 1974).
Morgan likened the condition to the Arnold-Chiari malformation in Man, which
consists of herniation of the inferior vermis, pons, medulla and the compressed
fourth ventricle through the foramen magnum, and he found it may be accom-
panied by shortening of the first cervical segment. A classification of the foramen
magnum defect, so-called occipital dysplasia, into three grades has been sug-
gested by Parker & Park (1974), but some of the dogs which they included in this
classification did not exhibit neurological signs and it is questionable whether
they should be regarded as abnormal.
In the author'.s experience the diagnosis of such cases can be difficult, especially
when assessing the true significance of certain of the radiographic findings. In an
endeavour to improve the understanding of some aspects of this condition an

0020-4510/79/0800-050 I $02.00 © _1979 BSA VA

501
502 J. A. WRIGHT RADIOGRAPHI C AN

investigation was undertaken which involved a comparison of the size of the

foramen magnum in apparently normal dogs with those showing clinical evidence
of the condition in question.

MATERIALS AND METHODS

Group 1
Radiographs were obtained of the foramena magna of seventeen dogs which
were referred to the Department for the investigation of conditions unrelated to
the upper cervical spine. The breeds represented included both those in which
problems relating to the upper cervical spine and occiput have been recorded and
those in which they have not. They comprised the following : Poodle, 4 (toy
variety, 2, miniature, 2); Yorkshire Terrier, 3 (toy variety 2, standard , I); Shih
Tzu , 2; Dachshund, 2; Pomeranian , I; Chihuahua, I; Beagle, I; Schnautzer, I;
Great Dane, I; Greyhound, I. They ranged in age from 3 months to 10 years:
average, 3.1 years.
General anaesthesia was routinely employed and each dog was held in the
appropriate position with sandbags and ties. The foramen magnum was radio-
graphed with the dog in dorsal recumbency, its head held at right angles to its
body. The tube head was tilted at a 30° angle from the vertical and the beam
directed mid-way between the orbits (Fig. 1). A Potter Bucky oscillating grid and
fast screens were employed for the larger breeds of dog, and detail screens without
the grid for smaller breeds. The focal film distance was 40 inches.
Tracings of the foramina magna were made from the radiographs. Care was
taken not to include the very thin part of the supraoccipital bone dorsal to the
foramen magnum which can often appear radiolucent on a radiograph and
simulate dorsal extension of the foramen magnum (Fig. 2a, b). The surface area of
the foramen magnum was calculated by impressing the tracing onto a piece of
card whose weight/cm 2 had been previously determined. The impression was then
cut out and weighed , and the surface area of the foramen magnum calculated
from this value.

Group 2
The same measurements were made on radiographs obtained from six dogs
referred to the Department for the investigation of a neurological problem related
to the cervical spine. Three (Yorkshire Terriers) were presented with cervical pain FIG . I. 14-year old female
or quadriplegia due, it was discovered , to atlanto-axial subluxation. The remain-
ing three (Yorkshire Terrier, 2; Maltese Terrier, 1) were ataxic and two of them
also showed cervical pain, but no atlanto-axial subluxation was detected. These
measurements were compared with those from Group I.
A post mortem examination was carried out on three Yorkshire Terriers from Group 1
Group 2, two of which died (Nos I and 4, Table 2) and the other was destroyed Comparison of the foram
(No . 2, Table 2). difference in size between
 RADIOGRAPHI C ANATOMY OF T HE FORAMEN MAGN U M IN DOGS 503
f the
lence

hich
:d to
hich
and
(toy
~hih
r, I ;
:ars:

the
::lio-
> its
!am
and
out

was
the
md
lOf
: of
1en
ted

)gS
ted
:un FIG. I. 14-year old female Toy Poodle. Radiographic positioning for the foramen
in- magnum.
em
ese
RESULTS
>m Group 1
ed Comparison of the foramina magna surface areas (Table I) showed that the
difference in size between the largest (Great Dane) and the smallest breed
504 J. A. WRIGHT RADIOGRAPHIC ANA

TABLE I. Foramin

Breed Age

Yorkshire Terrier
(Standard) I 3 years
(Toy) 2 7 years
(Toy) 3 I year
Range
Poodle
(Miniature) I 10 years
(Miniature) 2 3 years
(Toy) 3 3 months
(Toy) 4 ~years
Range
Shih Tzu I 18 months
2 I year
Pomeranian 3-! years
Chihuahua I year
Dachshund 5 years
2 5 years
Beagle 6 years
Great Dane 6 months
Greyhound 3 months
Schnautzer 6 months

(Chihuahua) was not large c

Great Dane, 60- 70 lbs; ly.o. t
in all the toy breeds studied, c
dorsal extension of the forarr
in the standard Yorkshire '
Greyhound and Great Dan1
magna were generally more r

Group 2
The foramina magna of th
dorsal extension (Fig. 3). In~
cm 2) than the range calculate<
was dorsal extension of the fo
FIG. 2. 10-year old male Poodle . a) Skull radiograph, foramen magnum view . A, dorsal the cervical spinal canal (Fig.
limit of the foramen magnum. B, area of supraoccipital bone dorsal to the foramen macerated skull of Yorkshire
magnum. b) Macerated skull. A and B pointing to similar areas as in a). that measured from the radic
Similar findings of dorsal e
 RADIOGRAPHI C ANATOMY OF THE FORAMEN MAGNUM IN D OGS 505

TABLE I. Foramina magna surface areas in 17 dogs from gro up I

Breed Age Sex Condition F /M area (cm 2)

Yorkshire Terrier
(Standard) 3 years M Brachial plexus avulsion 1·5
(Toy) 2 7 years M T /L i jv disc protrusion 2· 16
(Toy) 3 I year M T / L i/v disc protrusion 1·5
Range 1·5- 2· 16
Poodle
(Miniature) 10 years M Fractured fem ur 2·33
(Miniature) 2 3 years F Cervical pain and pyrexia 3·0
(Toy) 3 3 months M Fracture radius and ulna 1·7
(Toy) 4 ~years M C i jv disc protrusion 1·9 1
Range 1·7- 3·0
Shih Tzu 18 months M Hip dysplasia 2·83
2 I year M L/S stenosis 2·3
Pomeranian 3t years M Patella luxation 2·5
Chihuahua I year M Fracture radius and ulna 1·83
Dachshund I 5 years F T /L i/v disc protrusion 2·5
2 5 years M T /L i/v disc protrusion 1·3
Beagle 6 years M Toxoplasmosis 2·5
Great Dane 6 months M Carpal valgus 3·66
Greyhound 3 months M Persistent vomiting 3·33
Schnautzer 6 months M Cervica l scoliosis 2·83

(Chihuahua) was not large considering their respective weight and size (6 m.o.
Great Dane, 60-70 lbs; ly.o . Chihuahua, 2- 3lbs). Furthermore, it was noted that
in all the toy breed s studied, and also the Miniature Poodle, there was evidence of
dorsal extension of the foramen magnum (Fig. 3). This was true to a lesser extent
in the standard Yorkshire Terrier, Dachshund, Beagle and Schnautzer. The
Greyhound and Great Dane showed no dorsal extension and their foramina
magna were generally more rounded.

Group 2
The foramina magna of three dogs with atlanto-axial subluxation all showed
dorsal extension (Fig. 3). In Yorkshire Terrier No. 1 (Table 2) it was smaller ( 1· 3
2
cm ) than the range calculated for Group 1 (Table 1). Despite the small area there
was dorsal extension of the foramen (Fig. 3) and herniation of the brain stem into
the cervical spinal canal (Fig. 4a). The foramen magnum size measured from the
macerated skull of Yorkshire Terrier No. 2 (Table 2) was smaller (1 ·5 cm 2) than
that measured from the radiograph (1·8 cm 2).
Similar findings of dorsal extension of the foramina magna were obtained for
 RADIOGRAPHIC ANAl
506 J. A. WRIGHT

Group

0
Yorkshire
Terrier
uD0 0
Yorkshire
Terrier
Yorkshire
Terrier
Poodle Poodle

2
0Poodle

3
2 3

{)
Poodle
[j a Q u
Shih Tzu Shih Tzu Pomeranian Chihuahua
0
Dachshund

4 2

0
Dachshund
0 0 0 0
Beagle Great Dane Greyhound Schnau tzer

Group 2

Q (J
Yorkshire
Terrier
Yorkshire
Terrier
0 Q0 0
Yorkshire
Terrier
Yorkshire
Terrier
Yorkshi re
Terrier
Mal t ese
Terrier

2 3 4 5

FIG. 3. Tracings of the foramina magna from twenty-three dogs. Groups I and 2.

TABLE 2. Foramina magna surface areas in six dogs from group 2

Breed Age Sex Condition F /M area

Yorkshire Terrier I 2-! years F Atlanto-axial subluxation 1·3

2 II months M Atlanto-axial subluxation 1·8
(macerated skull) 1·5 FIG. 4. a) 2!-year old Yorkshir
Atlanto-axial subluxation 2·0 showing dorsal extension of th
3
4 3 years M Ataxia 2·3 with part of the herniated br
Ataxia and cervical pain 1·7 Post-mortem specimen of the
5 18 months M
magnum .
Maltese Terrier 3 years F Ataxia and cervical pain 1·5
 RADIOGRAPHIC ANATOMY OF THE FORAMEN MAGNUM IN DOGS 507

)
er

)
;e

2.

FIG. 4. a) 2t-year old Yorkshire Terrier I, (Group 2). Post mortem specimen of the skull
showing dorsal extension of the foramen magnum (A). The cerebellum is visible together
with part of the herniated brain stem. b) 3-year old Yorkshire Terrier 4 (Group 2).
Post-mortem specimen of the skull. The cerebellum (X) is visible through the foramen
magnum .
508 J. A. WRIGHT J. small Anim. Pract. ( 1979) 20, 5(

the three ataxic dogs without atlanto-axial subluxation. There appeared to be an

increased surface area in one dog (Yorkshire Terrier No. 4, Table 2) , but post
mortem examination revealed no herniation of the cerebellum, although it was
visible through the foramen magnum, (Fig. 4b).
Histological examination of two dogs (Yorkshire Terriers, Nos I and 2, Table Ne
2) with atlanto-axial subluxation revealed axon degeneration in the cranial
regions of the cervical spinal cord, together with infiltration of red blood cells into
the white and grey matter. In the ataxic dog which had an increased foramen
France
magnum surface area (Yorkshire Terrier No . 4) a major lesion was found in the News from C.N. V.S.P .A.
rostral lobes of the cerebral hemispheres. There was myelomalacia with pro- Na tionale des Veterinaires Special
nounced perivascular cuffing. Animaux- French Small Anim~
Association)
(I) The Officers are as follows :
DISCUSSION H onorary a nd Past President: Dr.
President: Dr. J . Fournier; Vice-f
The shape of the foramen magnum in the toy breeds studies showed dorsal J. Meynard and Dr J. Milin; Ho
extension in all cases (Fig. 3). This is interesting because similar findings were tary: Dr G . Pezieres; Assistant to
recorded by Parker & Park (1974) as being indicative of occipital dysplasia. retary and Editor of ' L'Animal de
Whether or not such extension represents a pathological process or is a normal Dr M . Gion Hon. Treasurer: Dr
Na tio nal Representative to theW
phenomenon in toy breeds remains a matter for speculation, but it is worthy of
R . Guerre
note that the shape of the foramen magnum was the same in both dogs with and (2) International Veterinary
without neurological symptoms. In one of these dogs (Yorkshire Terrier No . 2, Medicine and Surgery of Pets (I
Fig. 4a) herniation of the brain stem through the foramen magnum was observed. June 1978 , Congres Internatiom
It is therefore conceivable that all the dogs in which dorsal extension was de M edecine et de Chirurgie des
apparent had the potential for a similar situation to occur. Compagnie- C. I.V.A.C.) This <
held a t the Palais des Congres, C.
In the one dog where there appeared to be an increase of foramen magnum size tiona! de Paris (C.I.P.) to celeb
(Yorkshire Terrier No . 4, Table 2) there was no cerebellar herniation , and the Anniversary of the C.N.V .S.P.1
clinical signs of ataxia evinced by this dog were attributable to myelomalacia items have been dealt with by re
within the cerebral hemispheres. It would therefore seem that an increase in the Australia, Canada, Federal Rep
size of the foramen magnum does not necessarily imply an abnormality at this many, Finland , France, Italy, J;
Sweden, United Kingdom , U.S.!
level. Examination of additional clinical material will help to throw further light
taneous translation was provide·
on the significance of such findings. guages (English, French, Gen
Spanish) for the main sessions; in 1
(English , French) for Short C01
REFERENCES a nd practical demonstrations. 1
HOERLEIN, B. F. (1971) Canine Neurology , Diagnosis and Treatment. p. 276. 2nd Edn. W.B.Saunders was attended by about 700 p~
Co , Philadelphia, London, Toronto . whom 500 were French and 200 '
KELLY, J.H . (1975) Occipital dysplasia and hydrocephalus in a toy poodle. Vet. Med. SAC. 70, following twenty-one countries: A
940- 941. tria , Belgium, Canada , Denm
MORGAN, J .P . (1972) Radiology in Veterinary Orthopaedics. p. 248. Lea and Febiger, Philadelphia. Republ ic of Germany, Finland ,
PARKER, A.J . & PARK, R .D. (1974) Occipital dysplasia in the dog. J. Am. Anim . Hosp. Ass. 10, Kenya , Malaysia , Morocco, 1\
520- 525. Norway, Poland , Spain, Sweden.
The Netherlands, United Kingdc
pre-publication (in English and f
main reports was available before
Some copies are still available on