SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2021
Clival fractures in children: a challenge in the trauma room setting!
Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Traumatic retroclival hematoma resulting in abducens nerve palsy: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Retroclival Epidural Hematoma in Pediatric Head Trauma: A Case Report and Comprehensive Literature Review.Journal of central nervous system disease · 2025Article
- Clival Fracture With Multiple Cranial Nerve Palsy Treated With a Halo Device: A Case Report and Literature Review.Cureus · 2024Article
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Authors and funding
5 authors.
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Abstract
objectiveA clival fracture is a rare but life-threatening traumatic brain injury in the adult and pediatric populations. To date, there are very few conclusive recommendations in the literature concerning the diagnosis and treatment of pediatric clival fractures.
methodsIn 2014 and 2015, two pediatric patients with severe blunt head trauma and clival fractures were evaluated and treated at a level I trauma center. Both cases are documented and supplemented by an extensive review of the literature focusing on the diagnostic workup, classification, and clinical course of clival fractures in children.
resultsThe clinical course of two children (8 and 9 years old) with clival fractures in concert with other intra- and extracranial injuries was analyzed. A total of 17 papers encompassing 37 patients (age range, 1-18 years) were included for a systematic review. The literature review revealed a mortality rate of 23% in pediatric patients with a clival fracture. Over 50% of the patients presented with cranial nerve damage, and two-thirds suffered from intracranial vascular damage or intracerebral bleeding.
conclusionsClival fractures are a very rare but severe consequence of blunt head trauma in the pediatric population and may be challenging to diagnose, especially in cases with an unfused sphenooccipital synchondrosis. Vascular damage following clival fractures appears to be as common in pediatric patients as in adults. Therefore, contrast-enhanced CT of the cervical spine and head and/or magnetic resonance angiography is strongly recommended to rule out vascular injury of the extra- and intracranial brain-supplying vessels within the trauma room setting.
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