Traumatic Clivus Epidural Hematoma: Case Report and Review of the Literature

• Author(s): Ratilal, B ; Castanho, P ; Vara Luiz, C ; Antunes, JO
• Date: 2006
• Persistent ID: http://hdl.handle.net/10400.17/198
• Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
• Subject(s): Adulto; Mulher; Fossa Craniana Posterior; Hematoma Epidural Craniano; Lesões Cervicais
• Document Type: Article
• Language: English

Description

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.