Fractures of the clivus: a contemporary series in the computed tomography era.

Neurosurgery
Pawel G OchalskiDavid O Okonkwo

Abstract

We report the morbidity and mortality associated with fractures of the clivus and discuss management approaches specific to this unique diagnostic entity. We performed a boolean search of our electronic medical record database to identify patients with fractures of the clivus that were diagnosed using computed tomography of the head. A retrospective imaging and chart analysis was completed to further characterize the fractures and to analyze outcomes. Between January 1999 and December 2007, 41 patients were identified with fractures of the clivus. We found a 0.21% overall incidence among all head-injured patients presenting to our institution and a 2.3% incidence among those patients with a cranial fracture. Ten of 41 patients (24.4%) died, and neurological and vascular complications associated with central cranial base fractures were observed in 19 of 41 patients (46%). Furthermore, associated cranial fractures remote from the central cranial base and associated intracranial hemorrhages were observed in 40 of 41 (97.6%) and 33 of 41 (80.5%) patients, respectively. In terms of outcomes, 26 of 41 patients (63.5%) had a Glasgow Coma Scale score of 12 or greater at the time of discharge from the hospital. We demonstrate a lower th...Continue Reading

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Citations

Dec 25, 2013·BMC Research Notes·Julia J E EversThomas T V Vordemvenne
Mar 3, 2011·Journal of Neurosurgery. Pediatrics·Pawel G OchalskiIan F Pollack
Aug 5, 2014·Neuroimaging Clinics of North America·Kristen L Baugnon, Patricia A Hudgins
Jun 29, 2011·Clinical Neuroradiology·E Hofmann, A Prescher
Apr 11, 2013·Expert Review of Pharmacoeconomics & Outcomes Research·Junji LinCarrie McAdam-Marx
Nov 22, 2015·International Journal of Oral and Maxillofacial Surgery·J R StephensB T Evans
Feb 12, 2014·The Laryngoscope·Thomas S LeeAndrew Darling
Apr 7, 2016·Clinical Neurology and Neurosurgery·Shadi Al-AfifJoachim K Krauss
Apr 2, 2014·The British Journal of Oral & Maxillofacial Surgery·Seung-Won ChungHyung-Sik Park
Oct 25, 2014·Journal of Neurosurgery·Alexander Winkler-SchwartzJudith Marcoux
Nov 4, 2016·British Journal of Neurosurgery·See Yung PhangPeter C Whitfield
Nov 7, 2016·Insights Into Imaging·Curtis Edward Offiah, Emily Day
Oct 23, 2014·Journal of Intensive Care Medicine·Ravi S Samraj, Erika L Stalets
Apr 20, 2018·Pediatric Neurosurgery·Amir H FarajiIan F Pollack

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