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Romero-López C, Torri JA, Butrón-Díaz C, Rocha-Romero S, Martín-Schrader I, Arteaga-Romero F. Displaced transverse clival fracture: Infrequent but mortal. J Clin Neurosci 2023; 110:61-62. [PMID: 36801771 DOI: 10.1016/j.jocn.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/29/2023] [Accepted: 02/08/2023] [Indexed: 02/21/2023]
Affiliation(s)
- C Romero-López
- Department of Neurosurgery, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, 41013 Seville, Spain.
| | - J A Torri
- Department of Neurosurgery, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, 41013 Seville, Spain
| | - C Butrón-Díaz
- Department of Neurosurgery, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, 41013 Seville, Spain
| | - S Rocha-Romero
- Department of Neurosurgery, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, 41013 Seville, Spain
| | - I Martín-Schrader
- Chief of Department of Neurosurgery, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, 41013 Seville, Spain
| | - F Arteaga-Romero
- Department of Neurosurgery, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot s/n, 41013 Seville, Spain
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Winkler-Schwartz A, Correa JA, Marcoux J. Clival fractures in a Level I trauma center. J Neurosurg 2015; 122:227-35. [DOI: 10.3171/2014.9.jns14245] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT
Clival fracture (CF) is rare among head traumas. The aim of this study was to explore how radiological features observed in CF reflect the clinical picture and mechanism of injury in such cases.
METHODS
Radiological data for patients with skull base fracture admitted to the Montreal General Hospital between February 2002 and October 2012 were obtained from the Quebec Trauma Registry and reviewed for CF. Identified CF was categorized by orientation and quality. Injury mechanism, clinical presentation, and follow-up outcome were obtained through retrospective chart review.
RESULTS
Of the 1738 patients with skull base fractures, 65 exhibited CF, representing 1.2% of the 5416 patients with traumatic brain injuries admitted during the period studied. Thirty-nine (60%) of the 65 CFs were obliquely oriented, 17 (26.2%) were longitudinal, and 9 (14%) were transverse. Twenty-nine (45%) of the 65 patients demonstrated linear fracture, 17 (26%) hairline, 10 (15%) diastatic, and 9 (14%) displaced. Cranial nerve deficits and vascular injury occurred in 13.8% and 7.7% of cases, respectively. Twenty-five patients (38.5%) died in hospital. The long-term Extended Glasgow Outcome Scale score was significantly lower in transverse compared with longitudinal and oblique fractures (p = 0.03 and 0.03, respectively) and lower in diastatic compared with displaced fractures (p = 0.05).
CONCLUSIONS
This study provides information on the largest CF population studied to date, expands the current CF classification to include fracture quality as well as orientation, and underscores the existence of significant differences in pathogenesis and clinical presentation of CF subtypes.
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Affiliation(s)
| | | | - Judith Marcoux
- Departments of 1Neurology and Neurosurgery and
- 3Department of Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada
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