Basilar Artery Herniation into the Sphenoid Sinus Secondary to Traumatic Skull Base Fractures: Case Report and Review of the Literature.
BACKGROUND
Traumatic clival fractures occur with less than 0.6% frequency and can be associated with significant neurovascular injuries. The most serious of these injuries is to the basilar artery in which the artery is dissected or is fully occluded, resulting in infarction of the brainstem and cerebellum. Among early reports of these injuries, postmortem autopsy showed entrapment, or incarceration, of the basilar artery at the clival fracture site. A literature search revealed 11 cases of entrapment of the basilar artery within a clival fracture.


CASE DESCRIPTION
This report describes a 59-year-old man after a motor vehicle crash with computed tomography showing a basilar artery herniation through a sphenoid sinus fracture. The patient subsequently developed brainstem and cerebellar infarcts.


CONCLUSIONS
Basilar artery incarceration and herniation through the sphenoid sinus is rare. Such an injury portends a poor prognosis. We discuss the relevant clinical imaging and review the literature.
['Wang|Arthur|A|', 'Wainwright|John|J|', 'Cooper|Jared|J|', 'Tenner|Michael S|MS|', 'Tandon|Adesh|A|']
D000063:Accidents, Traffic D001344:Autopsy D001488:Basilar Artery D000072226:Computed Tomography Angiography D003388:Cranial Fossa, Posterior D038524:Diffusion Magnetic Resonance Imaging D015600:Glasgow Coma Scale D006801:Humans D021621:Imaging, Three-Dimensional D008297:Male D008875:Middle Aged D020205:Skull Fracture, Basilar D013101:Sphenoid Sinus
Basilar artery Herniation Sphenoid sinus