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Primary clival mucocele: case report.

Yasunori Fujimoto1, Yu Harada, Shingo Toyota

  • 1Department of Neurosurgery, Osaka Neurological Institute, Toyonaka Osaka, Japan. yasufujimoto@gmail.com

Neurologia Medico-Chirurgica
|March 29, 2011
PubMed
Summary

A rare clival mucocele caused abducens nerve palsy and diplopia. Endoscopic endonasal surgery successfully treated the condition, suggesting pneumatization as a potential cause.

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Area of Science:

  • Neurosurgery
  • Otolaryngology
  • Neurology

Background:

  • Clival masses are rare and can cause significant neurological deficits.
  • Abducens nerve palsy, presenting as diplopia, is a potential symptom of clival pathologies.
  • Endoscopic endonasal transsphenoidal surgery offers a minimally invasive approach for clival lesion management.

Observation:

  • A 40-year-old male presented with acute onset diplopia due to left abducens nerve palsy.
  • Neuroimaging identified a cystic clival mass eroding the posterior clival wall.
  • The patient underwent successful endoscopic endonasal drainage of the lesion.

Findings:

  • Intraoperative and histological examination confirmed the diagnosis of a mucocele.
  • The mucocele was uniquely localized to the clivus.

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  • Pneumatization of the clivus is hypothesized as a contributing factor to its development.

    • Implications:

    • This case highlights the importance of considering uncommon pathologies like clival mucoceles in the differential diagnosis of abducens nerve palsy.
    • Endoscopic endonasal transsphenoidal surgery is an effective treatment for clival mucoceles.
    • Further research into the pathogenesis of clival mucoceles, potentially involving clival pneumatization, is warranted.