Arthur Wang1, John Wainwright2, Jared Cooper2, Michael S Tenner3, Adesh Tandon2. 1. Department of Neurological Surgery, New York Medical College, Westchester, New York, USA. Electronic address: wanga@wcmc.com. 2. Department of Neurological Surgery, New York Medical College, Westchester, New York, USA. 3. Department of Radiology, New York Medical College, Westchester, New York, USA.
Abstract
BACKGROUND: Traumatic clival fractures occur with less than 0.6% frequency and can be associated with significant neurovascular injuries. The most serious of these injuries is to the basilar artery in which the artery is dissected or is fully occluded, resulting in infarction of the brainstem and cerebellum. Among early reports of these injuries, postmortem autopsy showed entrapment, or incarceration, of the basilar artery at the clival fracture site. A literature search revealed 11 cases of entrapment of the basilar artery within a clival fracture. CASE DESCRIPTION: This report describes a 59-year-old man after a motor vehicle crash with computed tomography showing a basilar artery herniation through a sphenoid sinus fracture. The patient subsequently developed brainstem and cerebellar infarcts. CONCLUSIONS: Basilar artery incarceration and herniation through the sphenoid sinus is rare. Such an injury portends a poor prognosis. We discuss the relevant clinical imaging and review the literature. Published by Elsevier Inc.
BACKGROUND:Traumatic clival fractures occur with less than 0.6% frequency and can be associated with significant neurovascular injuries. The most serious of these injuries is to the basilar artery in which the artery is dissected or is fully occluded, resulting in infarction of the brainstem and cerebellum. Among early reports of these injuries, postmortem autopsy showed entrapment, or incarceration, of the basilar artery at the clival fracture site. A literature search revealed 11 cases of entrapment of the basilar artery within a clival fracture. CASE DESCRIPTION: This report describes a 59-year-old man after a motor vehicle crash with computed tomography showing a basilar artery herniation through a sphenoid sinus fracture. The patient subsequently developed brainstem and cerebellar infarcts. CONCLUSIONS: Basilar artery incarceration and herniation through the sphenoid sinus is rare. Such an injury portends a poor prognosis. We discuss the relevant clinical imaging and review the literature. Published by Elsevier Inc.
Authors: Tjerk J Lagrand; Vincent A J Bruijnes; A M Madeleine Van der Stouwe; Eric A Deckers; Aryan Mazuri; Bram Jacobs Journal: Neurotrauma Rep Date: 2020-09-14