Posttraumatic retroclival hematoma: a case report

Excerpt

A 12-year-old boy with Down syndrome presented at the emergency department with headache, nausea and vomiting after a fall on the head. Clinical examination was unremarkable. CT of the brain revealed an extra-axial hyperdense lesion against the clivus (Fig. 1a) with mass effect on the brainstem (Fig. 1b). There was no clival fracture. The age of the patient and imaging characteristics led to the diagnosis of an extra-axial retroclival hematoma. Control MRI five days later confirmed a subacute, T1-hyperintense and T2-hypointense epidural hematoma extending from the dorsum sella to the basion (Fig. 2) which had already decreased in size. In addition, a subtle epidural hematoma against the opisthion was visualized, (Figs. 1a, 2). There was no ligamentous injury of the craniocervical junction. After one week of conservative therapy, the patient was discharged home. …