Traumatic retroclival hematoma [Neurosurgery Wiki]

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====== Traumatic retroclival hematoma ======

===== Epidemiology =====

Traumatic [[retroclival hematoma]]s are a rare entity. 

Typically, they are [[epidural hematoma]]s in pediatric patients. 


[[Subdural hematoma]]s and adult cases are sporadic. The 35 reported cases include 27 pediatric cases of epidural hematoma, 2 pediatric cases of subdural hematoma, 4 adult cases of epidural hematoma and 2 adult cases of subdural hematoma
((Tubbs RS, Griessenauer CJ, Hankinson T, Rozzelle C, Wellons JC, Blount JP et al.
Retroclival epidural hematomas: a clinical series. Neurosurgery 2010; 67:
404–406.))
((Oliviero A, Insola A, Santilli V, Tartaglione T, Profice P, Tonali P et al. Concomitant posttraumatic
cranio-cervical junction epidural hematoma and pontomedullary junction
infarction: clinical, neurophysiologic, and neuroradiologic features. Spine (Phila Pa
1976) 2000; 25: 888–890.))
((Ratilal B, Castanho P, Vara Luiz C, Oliveira Antunes J. Traumatic clivus epidural
hematoma: case report and review of the literature. Surg Neurol 2006; 66:
200–202.))
((Khan N, Zumstein B. Transverse clivus fracture: case presentation and significance of
clinico-anatomic correlations. Surg Neurol 2000; 54: 171–177.))
((Fuentes S, Bouillot P, Dufour H, Grisoli F. [Occipital condyle fractures and
clivus epidural hematoma. Case report] [Article in French]. Neurochirurgie 2000;
46: 563–567.)).

===== Etiology =====

They are usually epidural hematomas (being the [[tectorial membrane]] the anterior anatomical limit) diagnosed in children in the context of high-energy trauma, typically motor vehicle accidents. Lesion mechanism is considered to be a cervical flexion–extension injury in the pediatric spine that combines ligamentous laxity and high fulcrum movement in the craniocervical junction. In children, associated atlanto-occipital dislocation and systemic injuries have been reported in a significant number of cases, but not as a constant, sine qua non association
((Tubbs RS, Griessenauer CJ, Hankinson T, Rozzelle C, Wellons JC, Blount JP et al.
Retroclival epidural hematomas: a clinical series. Neurosurgery 2010; 67:
404–406.)).