Longitudinal clivus fracture associated with trapped basilar artery: unusual survival with good neurological recovery

Bala, Arul; Knuckey, Neville W.; Wong, Gary K. W.; Lee, G.Y.F

doi:10.1016/j.jocn.2003.11.008

Cited by 30 publications

(35 citation statements)

References 14 publications

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“…In addition, vascular injury was most often implicated in oblique or transverse orientations (Table 3). Longitudinal CFs have been traditionally implicated in basilar artery entrapment, 3,12,44 and oblique or transverse fractures have been often implicated in damage to the carotid arteries. 7,24,29,33 Somewhat unexpectedly, there were no instances of basilar artery entrapment in our cohort.…”

Section: Associated Injuriesmentioning

confidence: 99%

“…tures 3,7,12,33,41,44 and damage to the anterior circulation and surrounding cranial nerves in oblique or transverse fractures; 7,24,29,33 however, defining clinical presentations according to CF orientation remains inconsistent in the literature. The objective of this study was therefore to introduce a system of CF classification according to degree of displacement as well as orientation, and to determine if clinical presentation, course, and outcome differ among these unique fracture subtypes.…”

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confidence: 99%

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Clival fractures in a Level I trauma center

Winkler-Schwartz¹,

Correa

Marcoux

2015

JNS

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Section: Associated Injuriesmentioning

confidence: 99%

mentioning

confidence: 99%

Clival fractures in a Level I trauma center

Winkler-Schwartz¹,

Correa

Marcoux

2015

JNS

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“…4) Longitudinal clival 4,7,8,11,14) Most cases of longitudinal clival fracture resulted in death (mortality rate 67-80%) or residual disability of the patient (mean age 40 years). Only four adult patients 2,7,11) (18,20,32, and 42 years old) suffered minimal neurological damage. Traumatic severe brain damage is often discovered in addition to brain stem damage or vascular accident in patients with clivus fracture.…”

Section: Discussionmentioning

confidence: 98%

“…3) A total of 51 cases of fractures of the clivus due to head injury have been reported, mostly in adults who suffered serious vascular and cranial nerve damage. [1][2][3][4][5][7][8][9][10][11][12][13][14][15][16][17][18] Longitudinal clival fractures were identified in 29 cases, including four in children.…”

Section: Introductionmentioning

confidence: 99%

Traumatic Longitudinal Clival Fracture in a Child -Case Report-

Ono

Uchida

Tanaka

et al. 2011

Neurol. Med. Chir.(Tokyo)

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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.

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“…To date, there are only a few reported cases of entrapment of vertebrobasilar vessels, and most of them were identified only by autopsy, which revealed occlusion or thrombosis of the trapped vessel within the fracture. 2 The suspected mechanism for vascular damage involves inertia of the brainstem carrying the basilar artery into the clivus fracture, which traps the vessel permanently occluding it. 3 In our c a s e , F i g u r e 2 C a l s o s h o w s gradual tapering of the basilar artery, a pattern suggestive of arterial dissection.…”

Section: Commentmentioning

confidence: 99%