Koshy June, Scheurkogel Merel M, Clough Lauren, Huisman Thierry A G M, Poretti Andrea, Bosemani Thangamadhan
Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Zayed Tower, Rm 4174, 1800 Orleans Street, Baltimore, MD, 21287-0842, USA.
Childs Nerv Syst. 2014 May;30(5):835-9. doi: 10.1007/s00381-014-2369-8. Epub 2014 Jan 28.
Retroclival hemorrhage in children may occur in three compartments, namely epidural, subdural, and subarachnoid, frequently secondary to trauma. Retroclival epidural hematoma may be associated with ligamentous injury, which may further result in instability at the craniocervical junction. Retroclival subdural hematoma may indicate a sentinel event for traumatic injury elsewhere within the brain or posterior fossa. Retroclival subarachnoid hemorrhage may have severe clinical consequences related to vasospasm.
Neuroimaging is essential in the recognition, localization, and characterization of retroclival hemorrhage into various compartments and for evaluating potential severe clinical consequences such as craniocervical junction instability, underlying traumatic brain injury, and ischemia secondary to vasospasm. The goal of this paper is to discuss the anatomy and biomechanics of the craniocervical junction as well as the neuroimaging findings associated with various compartments of retroclival hemorrhage in children.
儿童斜坡后出血可发生在三个腔隙，即硬膜外、硬膜下和蛛网膜下腔，常继发于外伤。斜坡后硬膜外血肿可能与韧带损伤有关，这可能进一步导致颅颈交界区不稳定。斜坡后硬膜下血肿可能提示脑内或后颅窝其他部位创伤性损伤的前哨事件。斜坡后蛛网膜下腔出血可能因血管痉挛而产生严重的临床后果。
神经影像学对于识别、定位斜坡后出血进入各个腔隙以及对其进行特征描述，并评估潜在的严重临床后果，如颅颈交界区不稳定、潜在的创伤性脑损伤以及血管痉挛继发的缺血至关重要。本文的目的是讨论颅颈交界区的解剖结构和生物力学，以及儿童斜坡后出血各个腔隙相关的神经影像学表现。
