Joslyn J N, Mirvis S E, Markowitz B
Department of Diagnostic Radiology, University of Maryland Medical System, Baltimore 21201.
Radiology. 1988 Mar;166(3):817-21. doi: 10.1148/radiology.166.3.3340778.
During a 20-month period, fractures of the clivus occurring after craniocerebral trauma were diagnosed with computed tomography (CT) in 11 patients. Five patients had longitudinally oriented fractures; these were fatal in four patients due to either vertebral-basilar artery occlusion, brain stem trauma, or both. Six other patients had transversely oriented fractures that extended through the carotid canal and petrous temporal bone. While less frequently contributing directly to mortality, transverse fractures were also associated with cerebrospinal fluid leaks (two patients) and a cavernous sinus-carotid fistula (one patient). They were not as frequently associated with Horner syndrome or cranial nerve deficits as suggested in the current literature. This retrospective evaluation reveals two distinct injury patterns that demonstrate a difference in related morbidity and mortality.
在20个月的时间里，11例颅脑外伤后发生斜坡骨折的患者通过计算机断层扫描（CT）得以确诊。5例患者有纵向骨折；其中4例因椎基底动脉闭塞、脑干损伤或两者皆有而死亡。另外6例患者有横向骨折，骨折延伸穿过颈动脉管和颞骨岩部。虽然横向骨折较少直接导致死亡，但也与脑脊液漏（2例患者）和海绵窦-颈动脉瘘（1例患者）有关。它们不像当前文献中所提示的那样常与霍纳综合征或颅神经缺损相关。这项回顾性评估揭示了两种不同的损伤模式，它们在相关的发病率和死亡率方面存在差异。
