RSS-Feed abonnieren
DOI: 10.1055/s-0030-1247629
© Thieme Medical Publishers
Computed Tomography and Magnetic Resonance Imaging of a Basilar Artery Herniation into the Sphenoid Sinus
Publikationsverlauf
Publikationsdatum:
29. Januar 2010 (online)
![](https://www.thieme-connect.de/media/sbs/201004/lookinside/thumbnails/10.1055-s-0030-1247629-1.jpg)
ABSTRACT
We report a rare case of herniation of a basilar artery into the sphenoid sinus after a traumatic skull base fracture. Computed tomographic angiography, magnetic resonance imaging, and cerebral angiogram demonstrated patency of the basilar artery through the fractured clivus at the time of injury, a very rare occurrence. The following day, the patient developed pontine and cerebellar infarcts. In a patient with clival fracture, we advocate fast assessment of vertebrobasilar system with CTA and early anticoagulation treatment in those with vascular entrapment.
KEYWORDS
Basilar artery - herniation - clivus - fracture - CT - MR
REFERENCES
- 1 Bala A, Knuckey N, Wong G, Lee G YF. Longitudinal clivus fracture associated with trapped basilar artery: unusual survival with good neurological recovery. J Clin Neurosci. 2004; 11 660-663
- 2 Corradino G, Wolf A L, Mirvis S, Joslyn J. Fractures of the clivus: classification and clinical features. Neurosurgery. 1990; 27 592-596
- 3 Kapila A, Chakeres D W. Clivus fracture: CT demonstration. J Comput Assist Tomogr. 1985; 9 1142-1144
- 4 Sanders B B, VanderArk G D. Transverse fracture of the clivus. J Neurosurg. 1973; 39 610-614
- 5 Joslyn J N, Mirvis S E, Markowitz B. Complex fractures of the clivus: diagnosis with CT and clinical outcome in 11 patients. Radiology. 1988; 166 817-821
- 6 Bank W O, Nelson P B, Drayer B P, Wilkins R H, Rosenbaum A E. Traumatic aneurysm of the basilar artery. AJR Am J Roentgenol. 1978; 130 975-977
- 7 Guha A, Fazl M, Cooper P W. Isolated basilar artery occlusion associated with a clivus fracture. Can J Neurol Sci. 1989; 16 81-83
- 8 Lindenberg R. Incarceration of a vertebral artery in the cleft of a longitudinal fracture of the skull. Case report. J Neurosurg. 1966; 24 908-910
- 9 Nezami A H, Bremer A M. Basilar artery occlusion in multiple trauma: case report. Neurosurgery. 1980; 7 267-270
- 10 Quintana F, Diez C, Gutierrez A, Diez M L, Austin O, Vazquez A. Traumatic aneurysm of the basilar artery. AJNR Am J Neuroradiol. 1996; 17 283-285
- 11 Woolsey R M, Chung H D. Fatal basilar artery occlusion following cervical spine injury. Paraplegia. 1979; 17 280-283
- 12 Sights Jr W P. Incarceration of the basilar artery in a fracture of the clivus. Case report. J Neurosurg. 1968; 28 588-591
- 13 Khan N, Zumstein B. Transverse clivus fracture: case presentation and significance of clinico-anatomic correlations. Surg Neurol. 2000; 54 171-177
- 14 Kaakaji R, Russell E J. Basilar artery herniation into the sphenoid sinus resulting in pontine and cerebellar infarction: demonstration by three-dimensional time-of-flight MR angiography. AJNR Am J Neuroradiol. 2004; 25 1348-1350
- 15 Taguchi Y, Matsuzawa M, Morishima H, Ono H, Oshima K, Hayakawa M. Incarceration of the basilar artery in a longitudinal fracture of the clivus: case report and literature review. J Trauma. 2000; 48 1148-1152
Matthew BobinskiM.D. Ph.D.
UC Davis Medical Center, 4860 Y Street
Suite 3100, Sacramento, CA 95817
eMail: Matthew.bobinski@ucdmc.ucdavis.edu