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Retroclival and spinal subdural hematoma after traumatic brain injury - A case report and literature review

BACKGROUND: Retroclival hematomas are rare and occur mostly in the pediatric population. They are variously attributed to trauma, apoplexy, and vascular lesions. With motor vehicle accidents (MVAs), the mechanism of traumatic injury is forced flexion and extension. There may also be associated cervi...

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Detalles Bibliográficos
Autores principales: Solorio-Pineda, Saúl, Nieves-Valerdi, Adriana Ailed, Franco-Jiménez, José Alfonso, Gutiérrez-Aceves, Guillermo Axayacalt, Buenrostro-Torres, Luis Manuel, Ruíz-Flores, Milton Inocencio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744770/
https://www.ncbi.nlm.nih.gov/pubmed/31528424
http://dx.doi.org/10.25259/SNI-11-2019
Descripción
Sumario:BACKGROUND: Retroclival hematomas are rare and occur mostly in the pediatric population. They are variously attributed to trauma, apoplexy, and vascular lesions. With motor vehicle accidents (MVAs), the mechanism of traumatic injury is forced flexion and extension. There may also be associated cervical spinal and/or clivus fractures warranting fusion. CASE DESCRIPTION: A 35-year-old male sustained a traumatic brain injury after a fall of 5 m at work. His Glasgow coma scale (GCS) on admission was 13 (M6V3O4). He had no cranial nerve deficits. The brain computed tomography (CT) showed a retroclival subdural hematoma that extended to the C2 level. CONCLUSIONS: Most retroclival hematomas are attributed to MVAs, and cranial CT and magnetic resonance studies typically demonstrate a combination of posterior fossa hemorrhage with retroclival hematomas (intra or extradural). Patients with retroclival hematomas but high GCS scores on admission usually have better prognoses following traumatic brain injuries attributed to MVA. Notable however is the frequent association with additional cervical and/or craniocervical injuries (e.g. such as odontoid fracture) that may warrant surgery/fusión.