title: A rare clival and sellar fracture with pneumatocephalus.
abstract: We present a case of clival and sellar complex fracture produced by an indirect mechanism. This previously healthy patient had an occipital trauma followed by epistaxis. CT showed a clival and sellar fracture with pneumatocephalus. The probable fracture mechanism was contre-coup injury, linked to cerebral shock-wave transmission. This type of fracture is generally observed in the anterior part of the skull base, in a low resistance area. Severe osteoporosis probably accounted for the unusual fracture site in this patient. A mechanism of direct clival transmission is discussed, together with the usual complications of sphenoid injuries.
authors.affiliation: Clinique d'ORL et de Chirurgie Cervico-Faciale, Hôpital Lariboisière, 2 rue Ambroise Paré, 75010, Paris, France. frederic.portier@bct.ap-hop-paris.fr
authors.forename: Frédéric
authors.initials: F
authors.lastname: Portier
authors.forename: Didier
authors.initials: D
authors.lastname: Salvan
authors.forename: Olivier
authors.initials: O
authors.lastname: Duruisseau
authors.forename: Philippe
authors.initials: P
authors.lastname: Herman
authors.forename: Patrice
authors.initials: P
authors.lastname: Tran Ba Huy
mesh_terms: D000368:Aged; D004844:Epistaxis / Q000209:etiology; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D010024:Osteoporosis / Q000150:complications; D011007:Pneumocephalus / Q000175:diagnosis* / Q000209:etiology*; D012658:Sella Turcica / Q000293:injuries*; D020205:Skull Fracture, Basilar / Q000175:diagnosis* / Q000209:etiology*; D014057:Tomography, X-Ray Computed