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clival fracture

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
Joon Cho, Chang Taek Moon, Hyun Seung Kang, Woo Jin Choe, Sang Keun Chang, Young Cho Koh, Hong Gee Roh
Vertebrobasilar junction entrapment due to a clivus fracture is a rare clinical observation. The present case report describes a 54-yr-old man who sustained a major craniofacial injury. The patient displayed a stuporous mental state (Glasgow Coma Scale [GCS]=8) and left hemiparesis (Grade 3). The initial computed tomography (CT) scan revealed a right subdural hemorrhage in the frontotemporal region, with a midline shift and longitudinal clival fracture. A decompressive craniectomy with removal of the hematoma was performed...
August 2008: Journal of Korean Medical Science
Iman Feiz-Erfan, Eric M Horn, Nicholas Theodore, Joseph M Zabramski, Jeffrey D Klopfenstein, Gregory P Lekovic, Felipe C Albuquerque, Shahram Partovi, Pamela W Goslar, Scott R Petersen
OBJECT: Skull base fractures are often associated with potentially devastating injuries to major neural arteries in the head and neck, but the incidence and pattern of this association are unknown. METHODS: Between April and September 2002, 1738 Level 1 trauma patients were admitted to St. Joseph's Hospital and Medical Center in Phoenix, Arizona. Among them, a skull base fracture was diagnosed in 78 patients following computed tomography (CT) scans. Seven patients had no neurovascular imaging performed and were excluded...
August 2007: Journal of Neurosurgery
Cevdet Yavuz, Altay Sencer, Serdar Kabataş, Murat Imer, Talat Kiriş, Faruk Unal
Fractures of the clivus are often associated with severe head trauma and have high mortality rates due to coexisting injury of the adjacent vessels, brain stem and lower cranial nerves. An early diagnosis is often not possible because of adherent problems, high mortality rate and inadequacy of emergency imaging. Diagnosis has recently become easier with high resolution bone window computed tomography studies. In this study, radiological and clinical findings of three patients with longitudinal clival fractures and severe head trauma have been presented and associated injuries and prognostic issues are discussed with reference to the limited number of similar cases in the English literature...
October 2006: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Anthony K Frempong-Boadu, Wesley A Faunce, Richard G Fessler
OBJECTIVE: We describe a series of seven consecutive patients treated with endoscopically assisted transoral surgery for decompression of high cervical and clival abnormalities. METHODS: Seven endoscopically assisted transoral procedures were performed at the University of Florida from September 1999 to April 2000 for irreducible compression at the cervicomedullary junction. The abnormalities encountered were primary basilar invagination from congenital craniovertebral junction malformation (two cases), irreducible rheumatoid cranial settling (one case), secondary basilar invagination caused by migration of odontoid fracture fragments (one case), pseudogout granulation mass (one case), clivus chordoma (one case), and Chiari malformation with associated basilar invagination (one case)...
November 2002: Neurosurgery
Frédéric Portier, Didier Salvan, Olivier Duruisseau, Philippe Herman, Patrice Tran Ba Huy
We present a case of clival and sellar complex fracture produced by an indirect mechanism. This previously healthy patient had an occipital trauma followed by epistaxis. CT showed a clival and sellar fracture with pneumatocephalus. The probable fracture mechanism was contre-coup injury, linked to cerebral shock-wave transmission. This type of fracture is generally observed in the anterior part of the skull base, in a low resistance area. Severe osteoporosis probably accounted for the unusual fracture site in this patient...
April 2002: Auris, Nasus, Larynx
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