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clival fracture

Amir H Faraji, Pawel G Ochalski, Alp Ozpinar, Jason E Blatt, Ian F Pollack
Traumatic clival fractures in the pediatric population are associated with high mortality rates. In our previously reported series, a subset of clival fractures were associated with traumatic diastasis of the surrounding clival synchondroses. Herein, we describe a pediatric case of an isolated traumatic diastasis of the clival synchondroses without clival fracture with significant injury to neurovascular structures. To our knowledge this is the first report to describe this entity. Careful radiological attention should be made towards the clival synchondroses in crushing head injuries to best tailor screening for cerebrovascular injury even in the absence of clival fractures...
April 19, 2018: Pediatric Neurosurgery
Bedia Gulen, Mustafa Serinken, Ozgur Karcioglu, Okkes Taha Kucukdagli
Clival fracture is a rare and serious injury, which mostly results in the death of the victim before reaching the hospital. The entity is hardly diagnosed in the early phase because of high mortality rates and deficiencies in completion of radiological imaging. The incidence of diagnoses increased year by year after the usage of computed tomography gained widespread availability. In this article, we aimed to present radiological and clinical characteristics of a 5-year-old patient brought to the emergency department after a motor vehicle accident...
April 2018: Pediatric Emergency Care
Nanthiya Sujijantarat, Matthew J Pierson, Joanna Kemp, Jeroen R Coppens
BACKGROUND: Traumatic intracranial aneurysms (TICAs) of the posterior circulation in the pediatric populations are rare. Only a few reports in the literature document basilar artery TICA in the pediatric population. These cases were typically associated with a clival fracture and commonly diagnosed weeks to months after trauma. We present a case of a patient with a basilar TICA diagnosed after a motor vehicle collision treated with staged trapping and review of the literature. CASE DESCRIPTION: We present a case of a 14-year-old boy who sustained a high-speed motor vehicle collision and developed a basilar trunk TICA identified on admission...
December 2017: World Neurosurgery
Rie Tohge, Makio Takahashi
Cases of cerebrospinal fluid (CSF) rhinorrhea due to clival fracture are rare. We present a case of bacterial meningitis with CSF rhinorrhea after a clival fracture. Heavily T2-weighted images showed a bone flap in the thinned clivus and fluid collection in the sphenoid sinus. CSF rhinorrhea developed at 1 month after mild trauma. The fracture may have been caused by the trauma and/or by the pressure gradient between the intracranial CSF space and the sphenoid sinus. A detailed history to identify trauma and an examination to detect bone defects in the skull base are necessary when patients present with bacterial meningitis and persistent rhinorrhea...
2017: Internal Medicine
Hajime Ono
No abstract text is available yet for this article.
2017: Internal Medicine
Arthur Wang, John Wainwright, Jared Cooper, Michael S Tenner, Adesh Tandon
BACKGROUND: Traumatic clival fractures occur with less than 0.6% frequency and can be associated with significant neurovascular injuries. The most serious of these injuries is to the basilar artery in which the artery is dissected or is fully occluded, resulting in infarction of the brainstem and cerebellum. Among early reports of these injuries, postmortem autopsy showed entrapment, or incarceration, of the basilar artery at the clival fracture site. A literature search revealed 11 cases of entrapment of the basilar artery within a clival fracture...
February 2017: World Neurosurgery
Akihiro Hirayama, Fuminari Komatsu, Kazuko Hotta, Masaaki Imai, Shinri Oda, Masami Shimoda, Mitsunori Matsumae
An 89-year-old male presented with cerebrospinal fluid (CSF) rhinorrhea associated with head trauma sustained as a pedestrian in a traffic accident. Computed tomography (CT) showed pneumocephalus and multiple cranial bone fractures, including the clivus. Although the CSF rhinorrhea was treated conservatively for a week, clinical symptoms did not improve and surgical repair was performed. Preoperative thin-sliced bone CT and steady-state magnetic resonance images revealed a bone defect at the middle clivus and a collection of CSF fluid from the clival fistula in the sphenoid sinus...
2016: Neurologia Medico-chirurgica
Mikail Inal, Nuray Bayar Muluk, Mehmet Faik Ozveren, Umut Orkun Çelebi, Gökçe Şimşek, Veysel Burulday, Mihrace Yasemin Karadeniz Bilgili
OBJECTIVES: Technological advancements in the diagnostic radiology recently permitted reviewing the normal anatomy through multidetector computed tomography (MDCT) imagination. The aim of this paper is retrospectively investigation of the clival foramen and canal through MDCT. MATERIALS AND METHODS: One hundred eighty-six MDCT scans were reviewed. First, images were taken at axial plane, and then coronal and sagittal reconstructions of raw data were performed. Later investigations were carried out on these three-dimensional images (3-D imaging)...
October 2015: Journal of Craniofacial Surgery
M Májovský, D Netuka, V Masopust, V Beneš
INTRODUCTION: Clivus is a central structure of the skull base located in the vicinity of the brainstem and vital brain vessels. Clival fractures are usually caused by a high-energy trauma. Cerebrospinal fluid leak is one of the most common complications. CASE REPORT: A middle-aged male sustained a mild head trauma, followed by a nasal cerebrospinal fluid leak. CT scan revealed the massive pneumocephalus and the fracture of the clivus in the posterior wall of the sphenoidal sinus...
July 2015: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Andrew J Grossbach, Taylor J Abel, Arnold H Menezes, Mathew A Howard
No abstract text is available yet for this article.
April 2013: Journal of Neurosurgery
Danilo Silva, Moshe Attia, Jothy Kandasamy, Marjan Alimi, Vijay K Anand, Theodore H Schwartz
BACKGROUND: Posterior clinoidectomy is a useful procedure for maximizing exposure to the interpeduncular cistern via transcranial approaches for basilar tip aneurysms and select intracranial tumors. The value of posterior clinoidectomy during endonasal endoscopic transclival surgery is not well described. METHODS: We performed endoscopic endonasal transsphenoidal extradural bilateral posterior clinoidectomy and dorsum sella removal on five silicon-injected cadaveric heads...
2012: Surgical Neurology International
Eric Wang
No abstract text is available yet for this article.
July 2012: Current Problems in Diagnostic Radiology
Benjamin Nicot, Johann Peltier, Cyrille Capel, Michel Lefranc, Anthony Fichten, Christine Desenclos, Patrick Toussaint, Daniel Le Gars
BACKGROUND: After reviewing the literature about sella turcica and spheno-occipital synchondrosis fracture, we present the case of a 6-year-old girl who suffered complex sphenoid bone fracture produced by an indirect mechanism. METHODS: The girl fell from her height after a blunt head injury due to a falling lamppost. RESULTS: Computer tomography (CT) scan showed occipital, sellar and clival fractures with pneumatocephalus. The probable fracture mechanism is contre-coup injury linked to osseous and brain oscillations after head trauma...
April 2012: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Jorge García-García, Miguel Villar-Garcia, Lorenzo Abad, Tomas Segura
No abstract text is available yet for this article.
May 2012: Archives of Neurology
Hajime Ono, Masashi Uchida, Yuichiro Tanaka, Katsuyuki Tanaka, Takuo Hashimoto
A 7-year-old boy presented with a longitudinal clival fracture following a traffic accident. The boy presented only with temporary unconsciousness despite suffering a fracture of the clivus. Fractures of the clivus are often caused by severe head trauma, and the mortality rate is high due to coexisting injury of the adjacent vessels, brain stem, and lower cranial nerves. Review of the radiological and clinical findings of longitudinal clival fractures found that all reported pediatric patients with longitudinal clival fracture, including the present case, suffered an occipital impact, whereas the majority of longitudinal clival fractures in adults occur following frontal or axial impact...
2011: Neurologia Medico-chirurgica
Michael Wemhoff, Rajan Jain, Jack Rock
BACKGROUND AND IMPORTANCE: Temporal bone and skull base pneumatization is a naturally occurring process that begins before birth and continues into early adulthood. Occasionally this process surpasses normal limits, resulting in hyperpneumatization, which is usually obvious, but on rare occasions may mimic more aggressive skull base disorders. An awareness of this rare anatomical variant may help clinicians avoid more extensive investigations. CLINICAL PRESENTATION: We present the case of a 37-year-old man with severe headache and multiple, partially opacified lytic lesions in the skull base noted after minor head trauma...
March 2012: Neurosurgery
Pawel G Ochalski, Matthew A Adamo, P David Adelson, David O Okonkwo, Ian F Pollack
OBJECT: Fractures of the clivus and traumatic diastases of the clival synchondroses are rare in the pediatric population. The incidence, outcome, and biomechanics associated with these fractures have been difficult to ascertain secondary to the lack of literature pertaining to their occurrence. METHODS: A Boolean search of the electronic medical record database at the Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, was performed to identify patients with fractures of the clivus that were diagnosed using CT of the head...
March 2011: Journal of Neurosurgery. Pediatrics
Pavan Khanna, Matthew Bobinski
We report a rare case of herniation of a basilar artery into the sphenoid sinus after a traumatic skull base fracture. Computed tomographic angiography, magnetic resonance imaging, and cerebral angiogram demonstrated patency of the basilar artery through the fractured clivus at the time of injury, a very rare occurrence. The following day, the patient developed pontine and cerebellar infarcts. In a patient with clival fracture, we advocate fast assessment of vertebrobasilar system with CTA and early anticoagulation treatment in those with vascular entrapment...
July 2010: Skull Base: Official Journal of North American Skull Base Society ... [et Al.]
Alberto A J Maillard, Richard G Urso, Amanda M Jarolimek
BACKGROUND: : A 4-year retrospective review of injury to the intracranial internal carotid artery at the skull base was undertaken to assess the impact of the injuries and their consequence in both the adult and the pediatric population. METHODS: : The trauma registry followed by confirmatory chart reviews provided the total number of admissions, the mode of injury, demographics, and subdivided the trauma patients into the different groupings used in this study...
March 2010: Journal of Trauma
Pawel G Ochalski, Richard M Spiro, Anthony Fabio, Amin B Kassam, David O Okonkwo
OBJECTIVE: We report the morbidity and mortality associated with fractures of the clivus and discuss management approaches specific to this unique diagnostic entity. METHODS: We performed a boolean search of our electronic medical record database to identify patients with fractures of the clivus that were diagnosed using computed tomography of the head. A retrospective imaging and chart analysis was completed to further characterize the fractures and to analyze outcomes...
December 2009: Neurosurgery
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