Neuroimaging
Sarah McWilliams in Practical Radiological Anatomy, 2011
RADIOLOGICAL ANATOMY The skull (Figs 1.1–1.3) The skull is made up of the frontal bone, occipital bone, parietal bones, temporal bone and sphenoid bone. The lambdoid suture lies posteriorly between the occipital bone and the temporal and parietal bones. The sagittal suture lies in the midline. The coronal suture lies transversely between the frontal and parietal bones. The bregma is the most superior point at the junction of the coronal and sagittal sutures. The lambda is the junction of the lambdoid and sagittal sutures. The clivus forms the anterior wall of the foramen magnum and part of the skull base; it is formed by the occipit and the sphenoid. The superior aspect of the clivus forms the posterior clinoid processes or dorsum sellae. The anterior clinoid processes arise from either side of the anterior aspect of the pituitary fossa or sella turcica. They are more widely spaced than the posterior clinoid processes. The crista galli is the perpendicular superior projection of the cribriform plate of the ethmoid bone seen on an anteroposterior (AP) view. The skull is divided into three cranial fossas: anterior, middle and posterior.
An unusual presentation of clival chordoma: a case report and review of the literature
Published in British Journal of Neurosurgery, 2020
Monther Andijani, Aimun Jamjoom, Antonia Togersen, Bhashkar Ram, Peter Bodkin, Mahmoud Kamel
Chordomas are rare bone tumours that are aggressive and locally invasive. When arising from the clivus, they typically present with cranial nerve deficits and headache. We report a case of a 58-year-old male who presented acutely with hydrocephalus and suspected encephalitis. He had evidence of clival erosion but no obvious tumour mass on imaging. After stabilisation, he developed CSF rhinorrhoea for which he underwent endoscopic repair. Biopsy samples diagnosed chordoma.
Isolated Bilateral Abducens Nerve Palsies Due to Metastasis to the Clivus from Adenocarcinoma in the Lung
Published in Neuro-Ophthalmology, 2005
Hiromasa Tsuda, Hiroshi Ishikawa, Noriko Saito, Tsuneo Kano, Ichiro Tsujino
Isolated bilateral abducens nerve palsies due to clivus tumor have rarely been reported. We report on a 71-year-old woman with isolated bilateral abducens nerve palsies probably caused by metastatic clivus tumor from an adenocarcinoma in the lung. She complained of diplopia due to right abducens nerve palsy. Two weeks later, left abducens nerve palsy also appeared. Cranial magnetic resonance imaging showed a gadolinium-enhanced lesion in the clivus. Computed tomography of the chest demonstrated a lesion in segment 9 of the left lung. Biopsy of this lesion confirmed adenocarcinoma. When we encounter isolated bilateral abducens nerve palsies, clivus tumor, including metastasis from lung carcinomas, should be considered.
Giant cell tumour of the clivus
Published in British Journal of Neurosurgery, 2008
R. Gupta, S. Mohindra, A. Mahore, S. N. Mathuriya, B. D. Radotra
Primary giant cell tumours of the craniospinal axes are rare lesions. These are benign, localized and lytic bony lesions with occasional malignant behaviour. Their clinical behaviour is unpredictable and, hence, management remains controversial. Radical excision of bony lesion, with adjuvant therapy helps in achieving the desired outcome. In the present communication, we present malignant giant cell tumour of clivus, managed successfully with surgical decompression and adjuvant therapy. Patient remains symptom-free at 2 years of follow-up.
Related Knowledge Centers
- Brain Stem
- Glossopharyngeal Nerve
- Parietal Bone
- Sphenoid Bone
- Temporal Bone
- Vagus Nerve
- Jugular Veins