Patients with developmental abnormalities at the craniovertebral junction caught my attention during training at Medical School and when working as a medical officer in Meru. The puzzling note was that, though the anomalies were developmental, they presented clinically with symptoms and signs in later life. The patients I saw at the time were all from the ethnic groups of Kikuyu and Meru. It was noted that more often than not the Medical Officers first seeing the patient did not make a correct diagnosis. This resulted in patients being subjected to unnecessary investigationsy and causing a delay in diagnosis. Other patients were given diagnoses of conditions not treatable whereas craniovertebral anomalies treated appropriately and in good time have a good outlook. The impetus was further strengthened by the the anatomy and neurosurgical mystique of junction. desire to understand the craniovertebral The aims of this study were: 1. To understand the anatomy of the craniovertebral junction; To define and classify craniovertebral elucidate their pathological basis; anomalies and To look at the clinical and radiological features of these conditions; 4. To look detection, treatment. into those factors that will result in early diagnosis, appropriate and early timely treatment.