Traumatic clivus epidural hematoma: case report and review of the literature.
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.
Ratilal
Bernardo
B
Department of Neurosurgery, Hospital São José, Lisboa, Portugal. bratilal@yahoo.com
Castanho
Pedro
P
Vara Luiz
Carlos
C
Antunes
João Oliveira
JO
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*