Q: What is the importance of the clivus? show answer

A: The clivus is the most profound bone of the skull base; it protects the brainstem and adjacent major vascular structures and provides mechanical support for the cranial vault.

Q: What is the risk for patients with a clival fracture? show answer

A: The main risk for patients with a clival fracture is neurovascular deficiencies due to the anatomic proximity to cranial nerves, the brainstem, and the vertebrobasilar artery. Fractures of the clivus have a high rate of complications.

Q: Which cranial nerves are at risk of injuries in clival fractures? show answer

A: Patients with clival fractures may present cranial nerve deficits, including II, III, IV, V, VI, VII, VIII, IX, and XI.

Q: Why do many patients with fractures of the clivus have bilateral VI nerve palsies? show answer

A: Many patients with a head injury presenting fractures of the clivus have bilateral VI nerve palsies due to the proximity of Durello’s canal to the lateral aspect of the clivus.

Q: Which is the modality of choice to identify CT clival fracture? show answer

A: CT is the modality of choice to identify clival fractures.

Q: What is the Corradino CT-based classification for clival fractures? show answer

A: The Corradino CT-based classification for fracture of the clivus is longitudinal, transverse, and oblique types, depending on the CT orientation.

Q: Which CT type of fracture of the clivus has the worst prognosis? show answer

A: Patients with longitudinal fractures of the clivus have the worst prognosis and higher mortality rate due to the associated injury to the brainstem and vascular brainstem injuries. Transverse and oblique fractures of the clivus have a better prognosis and are most frequently associated with vascular injury of anterior circulation.

Q: What condition is associated with poor prognosis in clival fractures? show answer

A: Many clival fractures have a poor prognosis due to proximity to the brainstem and the high incidence of vascular injury. A vertebrobasilar artery occlusion trapping has a poor prognosis.