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A rare clival and sellar fracture with pneumatocephalus
Frédéric Portier1, Didier Salvan, Olivier Duruisseau
1Clinique d'ORL et de Chirurgie Cervico-Faciale, Hôpital Lariboisière, 2 rue Ambroise Paré, 75010, Paris, France. frederic.portier@bct.ap-hop-paris.fr
Abstract:
We present a case of clival and sellar complex fracture produced by an indirect mechanism. This previously healthy patient had an occipital trauma followed by epistaxis. CT showed a clival and sellar fracture with pneumatocephalus. The probable fracture mechanism was contre-coup injury, linked to cerebral shock-wave transmission. This type of fracture is generally observed in the anterior part of the skull base, in a low resistance area. Severe osteoporosis probably accounted for the unusual fracture site in this patient. A mechanism of direct clival transmission is discussed, together with the usual complications of sphenoid injuries.