Clivus Epidural Hematoma: A Case Report

Orrison, William W.; Rogde, Sidsel; Kinard, Richard E.; Williams, John E.; Torvik, Ansgar; Sackett, Joseph F.; Amundsen, Per

doi:10.1227/00006123-198602000-00014

Cited by 37 publications

(22 citation statements)

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“…The main clinical property of traumatic clival epidural, or interdural, is that hematomas are frequently associated with low GCS levels (14,19). Severe injuries, such as, longitudinal clivus fracture, atlantoaxial dislocation, clival dural laceration and entrapment of the vertebrobasilar artery complex have been reported in these patients (5,18,19,24). In trauma cases, it is possible to mechanically peel off the clival dura mater from below to above, by distraction of the dens towards the superior direction.…”

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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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: 77%

“…1,2,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]20,22,23) Most reported cases have been noted in pediatric patients after motor vehicle accidents involving the cervical spine. Here we report another case of traumatic retroclival EDH in a child.…”

Section: Introductionmentioning

confidence: 99%

Traumatic Retroclival Epidural Hematoma in a Child -Case Report-

Kwon

Joy

Park

et al. 2008

Neurol. Med. Chir.(Tokyo)

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“…From a review of the literature, we found only 8 cases (Table 1) [1,[6][7][8][9][10]12,13]. Remarkably, all cases, including ours, were a consequence of motor vehicle high-energy accidents.…”

Section: Discussionmentioning

confidence: 79%

Traumatic clivus epidural hematoma: case report and review of the literature

et al. 2006

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Background: Traumatic clival epidural hematoma is an extremely rare reported entity. Case Description: We describe the case of a 26-year-old woman involved in a car accident who presented with a Glasgow Coma Scale score of 13, bilateral abducens palsy, bilateral numbness on the mandibular territory of the trigeminal nerve, and left hypoglossal palsy. Radiological examinations revealed a clival epidural hematoma. The patient was managed conservatively, with clinical improvement of her neurological condition. This is the first traumatic clival epidural hematoma reported in an adult. From a review of the literature, we found only 8 cases. Conclusion:The pathophysiology of these hematomas is still a subject of debate; occipitoatlantoaxial ligamentous instability may play a role in it. In one third of the cases, bilateral cranial nerve palsies were associated. Apparently, they have a benign outcome. D

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Clivus Epidural Hematoma: A Case Report

Abstract: An acute traumatic epidural hematoma extending from the odontoid process to the dorsum sella is described. The mechanism for the formation of an extradural hematoma in this unusual location seems to be related to age and a severe hyperflexion injury.

Cited by 37 publications

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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-

Traumatic clivus epidural hematoma: case report and review of the literature

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