Ulus Travma Acil Cerrahi Derg. 2006; 12(4): 321-325

Longitudinal Clival Fractures: A Report of three Cases

Cevdet Yavuz¹, Altay Sencer², Serdar Kabataþ², Murat Ýmer², Talat Kýrýþ², Faruk Ünal^2
1Department Of Neurosurgery, Abant Ýzzet Baysal University, Düzce Medicine Faculty, Düzce, Turkey
²Department Of Neurosurgery, Ýstanbul University, Ýstanbul Medicine Faculty, Ýstanbul, Turkey

Fractures of the clivus are often associated with severe head trauma and have high mortality rates due to coexisting injury of the adjacent vessels, brain stem and lower cranial nerves. An early diagnosis is often not possible because of adherent problems, high mortality rate and inadequacy of emergency imaging. Diagnosis has recently become easier with high resolution bone window computed tomography studies. In this study, radiological and clinical findings of three patients with longitudinal clival fractures and severe head trauma have been presented and associated injuries and prognostic issues are discussed with reference to the limited number of similar cases in the English literature.

Keywords: Head trauma, longitudinal fracture of the clivus; skull fractures/ classification/ pathophysiology; tomography, X-ray computed.

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Longitudinal Klivus Kýrýðý: Üç olgu sunumu

Cevdet Yavuz¹, Altay Sencer², Serdar Kabataþ², Murat Ýmer², Talat Kýrýþ², Faruk Ünal^2
1Abant Ýzzet Baysal Üniversitesi Düzce Týp Fakültesi Nöroþirürji Anabilim Dalý, Düzce, Türkiye
²Ý.ü., Ýstanbul Týp Fakültesi, Nöroþirürji Anabilim Dalý, Ýstanbul, Türkiye

Genellikle þiddetli kafa travmasýna eþlik ettiði bildirilen klivus kýrýðý vertebrobaziler sistem, beyin sapý ve alt kraniyal sinir yaralanmalarýna baðlý olarak yüksek mortaliteye sahiptir. Klivus kýrýðýnýn tanýsý erken dönemde yüksek mortalite oraný ve acil radyolojik tekniklerin yetersiz olmasýndan dolayý nadiren konur. Ancak, yüksek çözünürlükte kemik pencere bilgisayarlý tomografi görüntüleme ile günümüzde taný kolaylaþmý þtýr. Bu yazýda, hafif (bir olgu) ve þiddetli (iki olgu) kafa travmasý sonrasý longitüdinal klivus kýrýðý saptanan üç hastadaki radyolojik ve klinik özellikler sunularak eþlik eden patolojiler ve prognoz açýsýndan önemi, literatürdeki az sayýda bildirilen olgulardan da yararlanýlarak tartýþýldý.

Anahtar Kelimeler: Kafa travmasý, klivusun longitüdinal kýrýðý; kafa kýrýklarý/sýnýþandýrma/fizyopatoloji; tomografi, X-ýþýný bilgisayarlý.

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