title: Traumatic entrapment of the vertebrobasilar junction due to a longitudinal clival fracture: a case report.
abstract: Vertebrobasilar junction entrapment due to a clivus fracture is a rare clinical observation. The present case report describes a 54-yr-old man who sustained a major craniofacial injury. The patient displayed a stuporous mental state (Glasgow Coma Scale [GCS]=8) and left hemiparesis (Grade 3). The initial computed tomography (CT) scan revealed a right subdural hemorrhage in the frontotemporal region, with a midline shift and longitudinal clival fracture. A decompressive craniectomy with removal of the hematoma was performed. Two days after surgery, a follow-up CT scan showed cerebellar and brain stem infarction, and a CT angiogram revealed occlusion of the left vertebral artery and entrapment of vertebrobasilar junction by the clival fracture. A decompressive suboccipital craniectomy was performed and the patient gradually recovered. This appears to be a rare case of traumatic vertebrobasilar junction entrapment due to a longitudinal clival fracture, including a cerebellar infarction caused by a left vertebral artery occlusion. A literature review is provided.
authors.affiliation: Department of Neurosurgery, Konkuk University Hospital, Gwangjin-gu, Seoul, Korea.
authors.forename: Joon
authors.initials: J
authors.lastname: Cho
authors.forename: Chang Taek
authors.initials: CT
authors.lastname: Moon
authors.forename: Hyun Seung
authors.initials: HS
authors.lastname: Kang
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Choe
authors.forename: Sang Keun
authors.initials: SK
authors.lastname: Chang
authors.forename: Young Cho
authors.initials: YC
authors.lastname: Koh
authors.forename: Hong Gee
authors.initials: HG
authors.lastname: Roh