Longitudinal clivus fracture associated with trapped basilar artery: unusual survival with good neurological recovery.
A 46-year-old motorcyclist sustained severe cranio-facial fractures from a fall at 60 km/h. He gradually developed a left hemiparesis and diplopia but retained a GCS of 15. CT head scan revealed a longitudinal clivus fracture. MRA of intracranial vessels identified a trapped basilar artery. The patient made an excellent recovery with residual left abducens palsy on follow-up at 10 weeks. Such recovery with minimal residual deficit in the context of this injury has not previously been reported. Reported cases to date are reviewed and causative mechanisms discussed.
Bala
A
A
Department of Neurosurgery, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia.
Knuckey
N
N
Wong
G
G
Lee
G Y F
GY
D000063:Accidents, Traffic; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000473:pathology; D001488:Basilar Artery / Q000293:injuries* / Q000473:pathology; D003388:Cranial Fossa, Posterior / Q000293:injuries* / Q000473:pathology; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology*; D012887:Skull Fractures / Q000473:pathology*; D014057:Tomography, X-Ray Computed