Spontaneous Clivus Hematoma: Case Report and Literature Review

Tomaras, Christopher; Horowitz, Barry L.; Harper, Richard P.

doi:10.1227/00006123-199507000-00018

Cited by 19 publications

(14 citation statements)

References 5 publications

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“…However, clival hematomas are not only caused by trauma, but may also occur spontaneously (4,9,25,26). Brock at al.…”

Section: Discussionmentioning

confidence: 99%

Subarachnoid, subdural and interdural spaces at the clival region: an anatomical study.

Ayberk¹,

Özveren²,

Aslan³

et al. 2011

Turkish Neurosurgery

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AIm:We aimed to show the significance of the anterior pontine membrane as a determining structure between the subdural and subarachnoid space in the clival region. mAterIAl and methOds: Five adult cadaver heads and five cerebral hemispheres were used. The skull vault and hemipheres were removed by sectioning through the pontomesencephalic junction. Five other heads hemispheres were removed but the arachnoid membrane was protected and the cerebral side of the clival dura mater was dissected. In another specimen, the dural porus of the abducens nerve was sectioned for histological evaluation. Three cases of hematoma at the clivus were presented to support our findings. results:The anterior pontine membrane is the arachnoid membrane forming the anterior wall of the prepontine cistern with its lateral extension at the skull base. This membrane forms the subdural and subarachnoid spaces by forming a barrier between the clival dura mater and neurovascular structures of the brainstem. There were rigid fibrous trabeculations between both cerebral and periosteal dural layers forming the basilar plexus as the interdural space in the clivus. COnClusIOn:The anterior pontine membrane separates the subdural and subarachnoid spaces at the clival region. The hematomas of the clival region require to be evaluated with consideration given to the existance of the subdural space.KeywOrds: Anterior pontine membrane, Arachnoid, Clivus, Interdural space ÖZ AmAÇ: Bu çalışmada, klival bölgedeki subdural ve subaraknoid mesafenin belirlenmesinde anterior pontin membranın önemini göstermek istedik. yÖntem ve GereÇ: Çalışmada beş yetişkin kadavranın kafatası ve beş serebral hemisfer kullanılmıştır. Kafatası ve hemisferler pontomezensefalik bileşke boyunca kesilerek çıkarılmıştır. Diğer beş hemisfer, araknoid membran korunarak çıkarılmış ve klival duramaterin serebral kısmı diseke edilmiştir. Bir başka spesmende, abdusens siniri dural porusu civarında histolojik kesit almak için kesilmiştir. Bulguları desteklemek için üç klival hematom vakası sunulmuştur.BulGulAr: Anterior pontin membran, prepontin sisternin anterior duvarını oluşturur ve kafa kaidesinin lateraline doğru uzanır. Bu membran, beyin sapının nörovaskuler yapıları ve klival dura dura mater arasında bariyer oluşturarak, subdural ve subaraknoid mesafenin oluşmasını sağlar. Klivusta baziler pleksusu oluşturan serebral ve periostal dural tabakalar arasında rijit fibröz trabekülasyonlar vardı. sOnuÇ: Anterior pontin membran, klival bölgede subdural ve subaraknoid mesafeleri ayırır. Klival bölgedeki hematomların, subdural mesafenin varlığı göz önüne alınarak değerlendirilmesi gerekir.

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“…However, clival hematomas are not only caused by trauma, but may also occur spontaneously (4,9,25,26). Brock at al.…”

Section: Discussionmentioning

confidence: 99%

Subarachnoid, subdural and interdural spaces at the clival region: an anatomical study.

Ayberk¹,

Özveren²,

Aslan³

et al. 2011

Turkish Neurosurgery

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“…Spontaneous or non-traumatic retroclival are also known in adults. 3,6,8,19,21) However, excluding such non-traumatic cases, only 20 cases of traumatic retroclival hematoma, including our case, have been reported (Table 1), 1,2,4,5,7,[9][10][11][12][13][14][15][16][17][18]20,22,23) and some striking clinical similarities can be found. Firstly, most cases occurred in the pediatric population, characteristically after a motor vehicle accident resulting in cervical hyperflexion or hyperextension injuries.…”

Section: Discussionmentioning

confidence: 76%

Traumatic Retroclival Epidural Hematoma in a Child -Case Report-

Kwon

Joy

Park

et al. 2008

Neurol. Med. Chir.(Tokyo)

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“…and pituitary apoplexy, 7,14 as well as spontaneous retroclival hemorrhage, 5,18,20 have been reported. To the best of our knowledge, 27 case reports of retroclival hemorrhage exist in the literature, and only 2 have been attributed to pituitary apoplexy.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous retroclival hematoma in pituitary apoplexy: case series

Azizyan¹,

Miller²,

Azzam³

et al. 2015

JNS

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OBJECT Pituitary apoplexy is a rare and potentially life-threatening disorder that is most commonly characterized by a combination of sudden headache, visual disturbance, and hypothalamic/hormonal dysfunction. In many cases, there is hemorrhagic infarction of an underlying pituitary adenoma. The resulting clinical symptoms are due to compression of the remaining pituitary, cavernous sinuses, or cranial nerves. However, there are only 2 case reports in the literature describing spontaneous retroclival expansion of hemorrhage secondary to pituitary apoplexy. Ten cases of this entity with a review of the literature are presented here. METHODS This is a single-institution retrospective review of 2598 patients with sellar and parasellar masses during the 10-year period between 1999 and 2009. The pituitary and brain MRI and MRI studies were reviewed by 2 neuroradiologists for evidence of apoplexy, with particular attention given to retroclival extension. RESULTS Eighteen patients (13 men and 5 women; mean age 54 years) were identified with presenting symptoms of sudden onset of headache and ophthalmoplegia, and laboratory findings consistent with pituitary apoplexy. Ten of these patients (8 men and 2 women; mean age 55 years) had imaging findings consistent with retroclival hematoma. CONCLUSIONS Retroclival hemorrhage was seen in the majority of cases of pituitary apoplexy (56%), suggesting that it is more common than previously thought.

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Spontaneous Clivus Hematoma: Case Report and Literature Review

Abstract: A spontaneous extra-axial hematoma extending from the dorsum sella to the foramen magnum is described. Although two cases of clivus epidural hematomas have been reported previously, review of the literature failed to reveal any case reports of spontaneous hematomas in this region.

Cited by 19 publications

References 5 publications

Subarachnoid, subdural and interdural spaces at the clival region: an anatomical study.

Subarachnoid, subdural and interdural spaces at the clival region: an anatomical study.

Traumatic Retroclival Epidural Hematoma in a Child -Case Report-

Spontaneous retroclival hematoma in pituitary apoplexy: case series

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