Traumatic entrapment of the vertebrobasilar junction due to a longitudinal clival fracture: a case report.
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.
Cho
Joon
J
Department of Neurosurgery, Konkuk University Hospital, Gwangjin-gu, Seoul, Korea.
Moon
Chang Taek
CT
Kang
Hyun Seung
HS
Choe
Woo Jin
WJ
Chang
Sang Keun
SK
Koh
Young Cho
YC
Roh
Hong Gee
HG