Cervical epidural haematoma with clivus fracture: case report.
Clivus fractures are rare and severe entities, usually associated with vascular or cranial nerve lesions and frequently diagnosed postmortem. Cervical epidural haematomas can be traumatic or spontaneous, manifested in acute or chronic form, and are treated surgically in the majority of cases, although the conservative treatment also can be indicated to patients with incomplete and non-progressive deficits. The authors report the case of a female patient, 8 years old, victim of trampling in public way by a high velocity motorized vehicle, admitted in Glasgow 7, anisocoric pupils (left pupil midriatic), whose radiological investigation showed a transverse fracture of the clivus, cervical epidural haematoma and diffuse axonal injury. The patient was submitted to intracranial pressure monitorization, sedation and conservative treatment with dexamethasone, with good outcome. The authors also present a literature review.
de Melo
Paulo Mácio Porto
PM
Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Kadri
Paulo Abdo do Seixo
PA
de Oliveira
Jean Gonçalves
JG
Suriano
Italo Capraro
IC
Cavalheiro
Sergio
S
Braga
Fernando Menezes
FM
D000063:Accidents, Traffic; D002574:Cervical Vertebrae; D002648:Child; D003388:Cranial Fossa, Posterior / Q000293:injuries; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D012887:Skull Fractures / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014057:Tomography, X-Ray Computed