title: Concomitant post-traumatic craniocervical junction epidural hematoma and pontomedullary junction infarction: clinical, neurophysiologic, and neuroradiologic features.
abstract: METHODS
  A case report.
  
  
  OBJECTIVE
  To report and discuss a case of post-traumatic epidural hematoma of the craniocervical junction with concomitant brain stem infarction.
  
  
  BACKGROUND
  Post-traumatic epidural hematoma of the cervical spine and brain stem post-traumatic infarction are very rare disorders. Post-traumatic epidural hematoma is usually located dorsally in the epidural space.
  
  
  METHODS
  The clinical, neuroradiologic, and neurophysiologic findings in one patient with post-traumatic epidural hematoma located ventrally at the cervicomedullary junction and associated with medial infarction at the pontomedullary junction are reported.
  
  
  RESULTS
  The main clinical finding in this patient was bilateral corticospinal and corticobulbar tract involvement. A magnetic resonance image showed displacement and flattening of the medulla oblongata and of the most cranial portion of cervical cord, which were caused by the epidural hematoma associated with an ischemic lesion of the pontomedullary junction. Results of central motor conduction studies indicated that the abnormality of the central motor pathways was localized at brain stem level, and that there was normal conduction from the cervicomedullary junction to spinal cord.
  
  
  CONCLUSIONS
  This is the first reported case of spinal epidural hematoma located ventrally in the cervical spine at the cervicomedullary junction level and concomitant infarction at the pontomedullary junction resulting from whiplash injury.
authors.affiliation: Istituto di Neurologia, Università Cattolica, Rome, Italy. Famiglia,
authors.forename: A
authors.initials: A
authors.lastname: Oliviero
authors.forename: A
authors.initials: A
authors.lastname: Insola
authors.forename: V
authors.initials: V
authors.lastname: Santilli
authors.forename: T
authors.initials: T
authors.lastname: Tartaglione
authors.forename: P
authors.initials: P
authors.lastname: Profice
authors.forename: P
authors.initials: P
authors.lastname: Tonali
authors.forename: V
authors.initials: V
authors.lastname: Di Lazzaro
mesh_terms: D000368:Aged; D020526:Brain Stem Infarctions / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008526:Medulla Oblongata; D011149:Pons; D014911:Whiplash Injuries / Q000150:complications*