Khan N, Zumstein B
Neurosurgery Department, University Hospital Zürich, Zürich, Switzerland.
Surg Neurol. 2000 Aug;54(2):171-7. doi: 10.1016/s0090-3019(00)00284-6.
Bilateral transverse basal skull fractures resulting from lateral crushing injuries involve fractures of the clivus that present clinically with multiple cranial nerve injuries and possible delayed vascular injuries due to the tight neural and vascular entry and exit routes present in this region. A case of a young patient with an extensive basal skull fracture is presented with description of the clinical signs and symptoms in relation to the neuroradiological findings. Clinico-anatomic correlations have been reiterated.
A case of a young patient suffering a bilateral crush injury resulting in a basal transverse clivus and petrous bone fracture is presented. Multiple cranial nerve injuries, unilateral and bilateral, were present (CN III, VI, VII). This clinical presentation correlated well with the anatomical location and extension of the respective cranial nerves at the level of the skull base and along the fracture line extending bilaterally through the clivus and petrous bone.
Initial neurological and neuroradiological investigations should be aimed at promptly detecting cranial nerve injuries and their correlating fracture injuries at the skull base. The possible development and progression of delayed neurological deficits should also be kept in mind and investigated.
由侧向挤压伤导致的双侧颅底横形骨折累及斜坡骨折，临床上表现为多条颅神经损伤，且由于该区域神经和血管进出路径紧密，可能出现延迟性血管损伤。本文介绍了一例患有广泛颅底骨折的年轻患者，并描述了与神经放射学检查结果相关的临床体征和症状。重申了临床与解剖学的相关性。
本文介绍了一例年轻患者，因双侧挤压伤导致颅底斜坡和岩骨横行骨折。存在多条单侧和双侧颅神经损伤（第三、第六、第七对颅神经）。这种临床表现与颅底水平及沿双侧穿过斜坡和岩骨的骨折线处各颅神经的解剖位置和延伸情况密切相关。
初始的神经学和神经放射学检查应旨在及时检测颅神经损伤及其在颅底的相关骨折损伤。还应牢记并调查延迟性神经功能缺损可能的发展和进展情况。
