Traumatic Entrapment of the Vertebrobasilar Junction Due to a Longitudinal Clival Fracture: A Case Report.
10.3346/jkms.2008.23.4.747
- Author:
Joon CHO
1
;
Chang Taek MOON
;
Hyun Seung KANG
;
Woo Jin CHOE
;
Sang Keun CHANG
;
Young Cho KOH
;
Hong Gee ROH
Author Information
1. Department of Neurosurgery, Konkuk University Hospital, Seoul, Korea. ctmoon@kuh.ac.kr
- Publication Type:Case Report ; Research Support, Non-U.S. Gov't ; Review
- Keywords:
Cranial Fossa, Posterior;
Skull Fracture, Basilar;
Vertebral artery;
Brain Infarction
- MeSH:
Basilar Artery/*injuries;
Humans;
Male;
Middle Aged;
Skull Fractures/*complications/radiography;
Tomography, X-Ray Computed;
Vertebral Artery/*injuries
- From:Journal of Korean Medical Science
2008;23(4):747-751
- CountryRepublic of Korea
- Language:English
-
Abstract:
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. Two days after surgery, a follow-up CT scan showed cerebellar and brain stem infarction, and a CT angiogram revealed occlusion of the left vertebral artery and entrapment of vertebrobasilar junction by the clival fracture. A decompressive suboccipital craniectomy was performed and the patient gradually recovered. This appears to be a rare case of traumatic vertebrobasilar junction entrapment due to a longitudinal clival fracture, including a cerebellar infarction caused by a left vertebral artery occlusion. A literature review is provided.
