Traumatic clivus epidural hematoma: case report and review of the literature

Surg Neurol. 2006 Aug;66(2):200-2; discussion 202. doi: 10.1016/j.surneu.2005.11.030.


Background: Traumatic clival epidural hematoma is an extremely rare reported entity.

Case description: We describe the case of a 26-year-old woman involved in a car accident who presented with a Glasgow Coma Scale score of 13, bilateral abducens palsy, bilateral numbness on the mandibular territory of the trigeminal nerve, and left hypoglossal palsy. Radiological examinations revealed a clival epidural hematoma. The patient was managed conservatively, with clinical improvement of her neurological condition. This is the first traumatic clival epidural hematoma reported in an adult. From a review of the literature, we found only 8 cases.

Conclusion: The pathophysiology of these hematomas is still a subject of debate; occipitoatlantoaxial ligamentous instability may play a role in it. In one third of the cases, bilateral cranial nerve palsies were associated. Apparently, they have a benign outcome.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Cranial Fossa, Posterior
  • Female
  • Hematoma, Epidural, Cranial / diagnosis*
  • Hematoma, Epidural, Cranial / etiology*
  • Hematoma, Epidural, Cranial / therapy
  • Humans
  • Whiplash Injuries / complications*