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KMID : 0191120080230040747
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Journal of Korean Medical Science
2008 Volume.23 No. 4 p.747 ~ p.751
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Traumatic Entrapment of the Vertebrobasilar Junction Due to a Longitudinal Clival Fracture: A Case Report
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Cho Joon
Roh Hong-Gee
Kang Hyun-Seung
Moon Chang-Taek
Chang Sang-Keun
Koh Young-Cho
Choe Woo-Jin
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Abstract
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Vertebrobasilar junction entrapment due to a clivus fracture is a rare clinical observation. The present case report describes a 54-yr-old man who sustained a major craniofacial injury. The patient displayed a stuporous mental state (Glasgow Coma Scale [GCS]=8) and left hemiparesis (Grade 3). The initial computed tomography (CT) scan revealed a right subdural hemorrhage in the frontotemporal region, with a midline shift and longitudinal clival fracture. A decompressive craniectomy with removal of the hematoma was performed. Two days after surgery, a follow-up CT scan showed cerebellar and brain stem infarction, and a CT angiogram revealed occlusion of the left vertebral artery and entrapment of vertebrobasilar junction by the clival fracture. A decompressive suboccipital craniectomy was performed and the patient gradually recovered. This appears to be a rare case of traumatic vertebrobasilar junction entrapment due to a longitudinal clival fracture, including a cerebellar infarction caused by a left vertebral artery occlusion. A literature review is provided.
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KEYWORD
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Cranial Fossa, Posterior, Skull Fracture, Basilar, Vertebral artery, Brain Infarction
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