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Fractures of the clivus and traumatic diastasis of the central skull base in the pediatric population.
- Source :
-
Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2011 Mar; Vol. 7 (3), pp. 261-7. - Publication Year :
- 2011
-
Abstract
- Object: Fractures of the clivus and traumatic diastases of the clival synchondroses are rare in the pediatric population. The incidence, outcome, and biomechanics associated with these fractures have been difficult to ascertain secondary to the lack of literature pertaining to their occurrence.<br />Methods: A Boolean search of the electronic medical record database at the Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, was performed to identify patients with fractures of the clivus that were diagnosed using CT of the head. A retrospective review of the chart and radiographic imaging was then performed to assess data regarding patient demographics, mechanism of injury, and skull and brain parenchymal injuries, as well as outcomes.<br />Results: Between May 2002 and November 2007, 16 patients with fractures of the clivus were identified. The mean age of these patients was 9 years (range 1-16 years). Eleven (68.8%) of the 16 patients had an associated traumatic diastasis of the central skull base. Five (31.3%) of the 16 patients died. However, of the 11 patients who survived, all had a good outcome with a Glasgow Outcome Scale score of 4 or 5 at the time of discharge. The incidence of clival fractures among patients with head injuries was 0.33%.<br />Conclusions: Clival fractures occur with a similar incidence in both the pediatric and adult trauma population. Outcome is not correlated directly with the extent of clival fracture, but rather with the presenting Glasgow Coma Scale score and concomitant brain parenchymal injuries. The identification of traumatic diastases in patients with clival fractures suggests that static loading forces are a significant factor in the biomechanics producing these types of fractures.
- Subjects :
- Adolescent
Biomechanical Phenomena
Child
Child, Preschool
Databases, Factual
Female
Glasgow Outcome Scale
Humans
Infant
Male
Radiography
Retrospective Studies
Skull Base surgery
Skull Fractures complications
Skull Fractures diagnostic imaging
Skull Fractures physiopathology
Treatment Outcome
Cranial Fossa, Posterior injuries
Skull Base injuries
Skull Fractures surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1933-0715
- Volume :
- 7
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of neurosurgery. Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 21361764
- Full Text :
- https://doi.org/10.3171/2010.12.PEDS10190