title: Retroclival Pneumocephalus Associated with Bilateral Abducens Palsy in a Child.
abstract: Traumatic brain injury (TBI) is less common in children than in adults. Posterior fossa lesions are even more uncommon, but, when present, are usually epidural hematomas. These lesions, even when small, may have a bad outcome because of the possibility of compression of the important structures that the infratentorial compartment contains, such as the brainstem and cranial nerves, and the constriction of the fourth ventricle, causing acute hydrocephalus. Although unusual, posterior fossa lesions are increasingly being diagnosed because of the better quality of and easier access to cranial tomography. In this paper, we report a case of a 12-year-old male patient who had suffered a TBI and presented with several pneumocephali, one of them in the retroclival region, causing a mass effect and then compression of the sixth cranial nerve which is the most susceptible to these injuries. We discuss these traumatic posterior fossa lesions, with an emphasis on retroclival pneumocephalus, not yet described in the literature in association with bilateral abducens palsy. In addition, we discuss associated lesions and the trauma mechanism.
authors.affiliation: Neurosurgery Division, Surgery Department, Faculdade de Cix00EA;ncias Mx00E9;dicas da Santa Casa de Sx00E3;o Paulo, Sx00E3;o Paulo, Brazil.
authors.forename: Aline Lariessy Campos
authors.initials: AL
authors.lastname: Paiva
authors.forename: Guilherme Brasileiro
authors.initials: GB
authors.lastname: de Aguiar
authors.forename: Vinicius Riccieri
authors.initials: VR
authors.lastname: Ferraz
authors.forename: João Luiz Vitorino
authors.initials: JL
authors.lastname: Araújo
authors.forename: Milton Hikaro
authors.initials: MH
authors.lastname: Toita
authors.forename: José Carlos Esteves
authors.initials: JC
authors.lastname: Veiga
mesh_terms: D020434:Abducens Nerve Diseases / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D002648:Child; D006801:Humans; D008297:Male; D011007:Pneumocephalus / Q000150:complications* / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery