title: Traumatic clivus epidural hematoma: case report and review of the literature.
abstract: BACKGROUND
  Traumatic clival epidural hematoma is an extremely rare reported entity.
  
  
  METHODS
  We describe the case of a 26-year-old woman involved in a car accident who presented with a Glasgow Coma Scale score of 13, bilateral abducens palsy, bilateral numbness on the mandibular territory of the trigeminal nerve, and left hypoglossal palsy. Radiological examinations revealed a clival epidural hematoma. The patient was managed conservatively, with clinical improvement of her neurological condition. This is the first traumatic clival epidural hematoma reported in an adult. From a review of the literature, we found only 8 cases.
  
  
  CONCLUSIONS
  The pathophysiology of these hematomas is still a subject of debate; occipitoatlantoaxial ligamentous instability may play a role in it. In one third of the cases, bilateral cranial nerve palsies were associated. Apparently, they have a benign outcome.
authors.affiliation: Department of Neurosurgery, Hospital São José, Lisboa, Portugal. bratilal@yahoo.com
authors.forename: Bernardo
authors.initials: B
authors.lastname: Ratilal
authors.forename: Pedro
authors.initials: P
authors.lastname: Castanho
authors.forename: Carlos
authors.initials: C
authors.lastname: Vara Luiz
authors.forename: João Oliveira
authors.initials: JO
authors.lastname: Antunes
mesh_terms: D000328:Adult; D003388:Cranial Fossa, Posterior; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D014911:Whiplash Injuries / Q000150:complications*