Symptoms of Basilar Invagination

Symptoms of basilar invagination occur due to pressure on the upper spinal cord or brainstem. Common symptoms include:

  • Posterior headache (pain at the back of the head)
  • Neck weakness
  • Periods of confusion
  • Dysarthria (difficulty swallowing or talking due to loss of muscle control)
  • Dizziness
  • Loss of sensation
  • Cranial nerve disturbance
  • Loss of the ability to know how joints are positioned
  • Lhermitte's sign (an “electric shock” sensation down the spine and/or to the extremities when the neck is flexed forward)
  • Weakness of the arms and legs
  • Orthostatic hypotension (dizziness on standing)


Symptoms may worsen with flexion or extension of the neck. Accurate diagnosis is critical to ensure proper treatment (see Diagnosing and Treating Basilar Invagination).

Complications may include hydrocephaluspseudotumor cerebri, or syringomyelia, because basilar invagination blocks the flow of fluid around the brain and spinal cord.


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What our Patients Say

Joe and Christine Pecoraro write about their son Caleb, who underwent surgery with Dr. Greenfield for basilar invagination and Chiari malformation.

Our Care Team

  • Vice Chairman for Academic Affairs
  • Associate Professor of Neurological Surgery, Pediatric Neurosurgery
  • Associate Residency Director
Phone: 212-746-2363
  • Vice Chair for Clinical Research
  • David and Ursel Barnes Professor in Minimally Invasive Surgery
  • Professor of Neurosurgery, Neurology, and Otolaryngology
  • Director, Center for Epilepsy and Pituitary Surgery
  • Co-Director, Surgical Neuro-oncology
Phone: 212-746-5620
  • Assistant Professor of Neurological Surgery
Phone: 646-962-3388

Reviewed by Jeffrey Greenfield, Ph.D., M.D. 
Last reviewed/last updated: April 2021

Weill Cornell Medicine Brain & Spine Center 525 East 68 Street, Box 99 New York, NY 10065 Phone: 866-426-7787