Entrapment of the basilar artery within a clivus fracture: Case report and literature review - 08/08/19

Doi : 10.1016/j.neuchi.2019.03.123

T. Metayer ^a,^⁎ , E. Emery ^a,^d, J. Cogez ^c, C. Barbier ^b, T. Gaberel ^a,^d
^a Department of Neurosurgery, Caen University hospital Normandy, avenue de la Côte-de-Nacre, 14000 Caen, France
^b Department of Radiology, Caen University hospital Normandy, 14000 Caen, France
^c Department of Neurology, Caen University hospital Normandy, 14000 Caen, France
^d UNICAEN, Inserm, UMR-S U1237, Normandie Université, Physiopathology and Imaging of Neurological Disorders (PhIND), GIP Cyceron, 14000 Caen, France

^⁎Corresponding author.

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Abstract

A review of the literature revealed that basilar artery (BA) entrapment is a very rare (17 cases published) and severe pathological condition, which often leads to death. We report the case of a 72-year-old man who presented with a longitudinal clivus fracture associated with a basilar artery entrapment. This entrapment was responsible for a basilar artery dissection, which led to an ischemic stroke in the pons. The patient was managed with medical treatment, mainly to avoid a progression towards an ischemic stroke. It consisted of heparin therapy followed by antiplatelet therapy, which finally resulted in a successful outcome. In BA entrapment most of the patients who had a favorable outcome received antithrombotic therapy. This suggests that antithrombotic therapy might be useful in the first line treatment of post-traumatic BA entrapment.

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Keywords : Clivus fracture, Basilar artery, Antithrombotic therapy, Arterial dissection