Background: Clivus fractures are highly uncommon. The classification by Corradino et al. divides the different lesions in longitudinal, transverse and oblique fractures. Longitudinal types are associated with the highest mortality rate between 67 - 80%. Clivus fractures are often found after high velocity trauma, especially traffic accidents and falls. The risk of neurologic lesions is high, because of the anatomic proximity to neurovascular structures like the brainstem, the vertebrobasilar artery, and the cranial nerves. Longitudinal clivus fractures have a special risk of causing entrapment of the basilar artery and thus ischemia of the brainstem.
Case Presentation: This lesion in our patient was a combination-fracture of the craniocervical junction with a transverse clivus fracture. In this case, the primary closed reduction of the clivus fracture and the immobilization with a halo device was the therapy of choice and led to consolidation of the fracture.
Conclusion: Therapy advices and examples in the literature are scarce. We present a patient with a clivus fracture, who could be well treated by a halo device. Through detailed research of the literature a therapy algorithm has been developed.
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http://dx.doi.org/10.1186/1756-0500-6-554 | DOI Listing |
J Orthop Trauma
January 2025
Department of Orthopaedic Surgery, UT Health Houston, Houston, TX.
Objectives: To report the frequency of patients with pre- and post-reduction computed tomography (CT) scans associated with acetabular fracture-dislocations and the change of associated intra-articular fragments occurring with joint reduction.
Methods: Design: Retrospective case series.
Setting: Regional Level 1 trauma center.
Cureus
September 2024
Department of Emergency Medicine and Critical Care, Saitama Medical Center, Saitama Medical University, Kawagoe, JPN.
Zh Nevrol Psikhiatr Im S S Korsakova
September 2024
Ivano-Matreninsk City Children's Clinical Hospital, Irkutsk, Russia.
In the presented clinical observation of complex therapy of severe combined trauma: severe brain contusion, subarachnoid hemorrhage, closed fracture of the occipital bone, closed compression fracture of Th-Th vertebral bodies, contusion of the lungs and kidneys, blunt abdominal trauma and closed fracture of both bones of the right leg in lower third with displacement) in a teenager after an accident, the need for dynamic introscopic examination of the patient is shown for timely detection of abnormalities in the state of brain structures and correction of treatment up to surgical intervention. The effectiveness of the inclusion of Cytoflavin in complex treatment regimens was noted in the form of positive dynamics of the clinical and introscopic picture. The results obtained may serve as a basis for further research.
View Article and Find Full Text PDFChilds Nerv Syst
December 2024
Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Front Neurol
July 2024
Department of Neurosurgery, China-Japan Friendship Hospital, Beijing, China.
Objective: To quantitatively study the measurement data related to the bony posterior cranial fossa and explore the correlation between bony posterior cranial fossa morphology and the occurrence of hemifacial spasm.
Methods: A total of 50 patients with hemifacial spasm who attended the Department of Neurosurgery of China-Japan Friendship Hospital from October 2021 to February 2022 were included, and 60 patients with minor head trauma excluding skull fracture and intracranial abnormalities were included as controls. Cranial multilayer spiral CTs (MSCTs) were performed in both groups, and multiplanar reconstruction (MPR) was used as a postprocessing method to measure data related to the posterior cranial fossa in both groups.
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