Traumatic clival subdural hematoma in an adult: Case report

• Published in: Journal of neurosurgery Vol. 110; no. 6; pp. 1238 - 1241
• Main Authors: CASEY, David, CHAUDHARY, Bedansh Roy, LEACH, Paul A, HERWADKAR, Amit, KARABATSOU, Konstantina
• Format: Journal Article
• Language: English
• Published: Charlottesville, VA American Association of Neurological Surgeons 01-06-2009
• Subjects: Biological and medical sciences; Medical sciences; Neurosurgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Vascular disease; Case study; Nervous system diseases; subdural hematoma; retroclival lesion; Cardiovascular disease; spinal hematoma; Clivus; Trauma
• ISSN: 0022-3085; 1933-0693
• DOI: 10.3171/2008.9.JNS17651

Retroclival hematomas are a rare entity. They are usually associated with significant trauma, and patients frequently have focal neurological deficits, especially cranial nerve palsies. Previous case reports of epidural clival hematomas have been described almost exclusively in the pediatric population. The authors report a unique case of traumatic clival subdural hematoma, which has never been described in an adult except in the context of hemophilia.
An 18-year-old man presented with continuing nausea and headaches following a seemingly trivial head injury. He was found to have a posterior fossa retroclival hematoma extending into the spinal subdural space but without any neurological deficits. He was treated conservatively, with a good outcome. The authors discuss the possible mechanisms of injury, management, and complications related to this rare condition, and they review the pertinent literature.