Clivus

Last revised by Patrick O'Shea on 10 Nov 2023

The clivus (of Blumenbach) is the sloping midline surface of the skull base anterior to the foramen magnum and posterior to the dorsum sellae 1. Specifically, it is formed by the sphenoid body and the basiocciput, which join at the spheno-occipital synchondrosis. At the clivus, the occipital bone has articulations with the petrous part of temporal bone at the petroclival fissure.

Inferiorly, the clivus is flanked by the rounded prominences of the jugular tubercles, which represents the fusion of the basiocciput with the lateral jugular parts of the occipital bone.

At the level of the jugular tubercles, the clivus is occupied by the medulla 1.

Above the jugular tubercles, the clivus is wider and occupied by the pons

Anatomically it is also closely related to the basilar venous plexus and pontine cistern.

There are multiple variant defects or channels through the clivus 4:

There are several occipital vertebrae variants in which bony protuberances arise from the clivus at the anterior margin of the foramen magnum 4:

On T1-weighted images, the signal intensity of clivus varies with age. In childhood, red haematopoetic bone marrow contributes to low signal intensity on T1-weighted images. As the child ages, the signal intensity of clivus becomes heterogenous with increasing infiltration of fatty marrow and subsequently become hyperintense in old age 5.

Blumenbach clivus, a term that is very rarely used, is named after the German physiologist Johann Friedrich Blumenbach (1752-1840) 3

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