====== 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.)).