This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pathology
[{'content': 'All of the following are the classical presentation of Craniovertebral junction anomalies except - \nSelect and explain. \nA. Pyramidal signs, B. Low hairline, C. Short neck, D. Pupillary asymmetry', 'role': 'user'}, {'content': "Answer: D \nExplanation: Craniovertebral anomalies\n\nCraniovertebral anomalies include congenital anomalies at the base of the skull and atlanto occipital region. It includes the occipito atlanto axial complex\nSymptoms and signs of craniovertebral junction anomalies\nSigns and symptoms of craniovertebral junction anomalies reflect the abnormalities and compromise of the following structures.\n\n\nPons\nMedulla\nCervicomedullary junction and upper cervical spinal cord\nLower cranial nerves\nCervical nerve roots\n\nVascular supply to the neural structures\n\nIn craniovertebral anomalies, there is involvement of so many neurological structures that it presents with the confusing neurological picture.\nA patient with congenital anomaly of craniovertebral junction usually presents with an abnormal physical appearance.\nCongenital anomalies included in craniovertebral anomalies also include Klippel-Feil syndrome and Down's syndrome.\nFindings in Klippel — Feil syndrome is\xa0\nHead cocked to one side\xa0\nShort neck\nAbnormally low hairline posteriorly\nLimitation of neck movement\n\nSome more important facts about craniovertebral junction anomaly \nThe most common neurological symptom is posterior occipital headache, that worsens with neck flexion and extension.\nMyelopathy with involvement of pyramidal tract is also a very common symptom associated with cranio vertebral anomaly.\nMost common cranial nerve dysfunction is hearing loss\nPupillary asymmetry usually results due to an abnormality of 2nd or 3rd nerve.\nThe 2nd nerve is cortical and 3rd\xa0nerve is related to the midbrain so quite obviously they will not get involved in craniovertebral junctional anomaly.", 'role': 'assistant'}]