The occipital bone forms the posterior and inferior cranium, featuring the foramen magnum through which the spinal cord passes, and two occipital condyles that articulate with the atlas vertebra to allow head nodding.
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| Ossification | Endochondral ossification from multiple centres that fuse progressively. The basioccipital synchondrosis between the occipital bone and sphenoid fuses at puberty, making it a useful forensic age indicator in adolescents. |
The foramen magnum transmits the medulla oblongata, vertebral arteries, and accessory nerves. Chiari malformation involves herniation of the cerebellar tonsils through the foramen magnum, producing headache, neck pain, and cerebellar symptoms. The occipital condyles articulate with the atlas and are the pivot for head nodding movements. Occipital condyle fractures from high-energy impact can cause lower cranial nerve palsies from jugular foramen compression.
High-energy trauma can fracture the occipital condyles at the craniocervical junction, causing upper neck pain and sometimes lower cranial nerve palsies; diagnosis usually requires CT.
Fractures of the occipital skull base may extend to the foramen magnum or jugular foramen, with risk of vascular, cranial nerve, and brainstem injury.
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