de Melo Paulo Mácio Porto, Kadri Paulo Abdo do Seixo, de Oliveira Jean Gonçalves, Suriano Italo Capraro, Cavalheiro Sergio, Braga Fernando Menezes
Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Arq Neuropsiquiatr. 2003 Jun;61(2B):499-502. doi: 10.1590/s0004-282x2003000300034. Epub 2003 Jul 28.
Clivus fractures are rare and severe entities, usually associated with vascular or cranial nerve lesions and frequently diagnosed postmortem. Cervical epidural haematomas can be traumatic or spontaneous, manifested in acute or chronic form, and are treated surgically in the majority of cases, although the conservative treatment also can be indicated to patients with incomplete and non-progressive deficits. The authors report the case of a female patient, 8 years old, victim of trampling in public way by a high velocity motorized vehicle, admitted in Glasgow 7, anisocoric pupils (left pupil midriatic), whose radiological investigation showed a transverse fracture of the clivus, cervical epidural haematoma and diffuse axonal injury. The patient was submitted to intracranial pressure monitorization, sedation and conservative treatment with dexamethasone, with good outcome. The authors also present a literature review.
斜坡骨折是罕见且严重的病症，通常与血管或颅神经损伤相关，且常于尸检时才得以诊断。颈椎硬膜外血肿可分为外伤性或自发性，有急性或慢性表现，多数情况下需手术治疗，不过对于存在不完全且无进展性神经功能缺损的患者也可采用保守治疗。作者报告了一例8岁女性患者的病例，该患者在公共道路上被高速机动车碾压，入院时格拉斯哥昏迷评分为7分，双侧瞳孔不等大（左侧瞳孔中度散大），影像学检查显示斜坡横行骨折、颈椎硬膜外血肿及弥漫性轴索损伤。患者接受了颅内压监测、镇静及地塞米松保守治疗，预后良好。作者还进行了文献综述。
