• Title/Summary/Keyword: Clivus

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Sixth Cranial Nerve Palsy Caused by Gastric Adenocarcinoma Metastasis to the Clivus

  • Lee, Aleum;Chang, Kee-Hyun;Hong, Hyunsook;Kim, Heekyung
    • Journal of Korean Neurosurgical Society
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    • v.57 no.3
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    • pp.208-210
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    • 2015
  • Tumors of the clivus and metastases to the clivus are very rare. Metastasis involving the clivus has previously been described in only two case reports. In skull metastasis, the breast and prostate are the most common primary foci, while metastasis from gastric carcinoma is extremely rare. A review of the English literature revealed only one published case of clivus metastases from gastric adenocarcinoma. There is no literature thoroughly explaining the differential diagnosis between chordoma and metastasis. Here we report a rare case of metastasis to the clivus from a gastric adenocarcinoma in a 42-year-old female patient with sudden blurry vision, presenting as bilateral cranial nerve VI palsy.

Anomalies of the clivus of interest in dental practice: A systematic review

  • McCartney, Troy E.;Mupparapu, Mel
    • Imaging Science in Dentistry
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    • v.51 no.4
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    • pp.351-361
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    • 2021
  • Purpose: The clivus is a region in the anterior section of the occipital bone that is commonly imaged on large-volume cone-beam computed tomography (CBCT). There have been several reports of incidental clivus variations and certain pathological entities that have been attributed to the variations. This study aimed to evaluate the effects of these variations within the scope of dentistry. Materials and Methods: Medical databases (PubMed, Scopus, and Web of Science) were searched using a controlled vocabulary (clival anomalies, cone-beam CT, canalis basilaris medianus, fossa navicularis magna, clival variation). The search was limited to English language, humans, and studies published in the last 25 years. The articles were exported into RefWorks® and duplicates were removed. The remaining articles were screened and reviewed for supporting information on variations of the clivus on CBCT imaging. Results: Canalis basilaris medianus and fossa navicularis magna were the most common anomalies noted. Many of these variations were asymptomatic, with most patients unaware of the anomaly. In certain cases, associated pathologies ranged from developmental (Tornwaldt cyst), to acquired (recurrent meningitis). While no distinct pathognomonic aspects were noted, there were unique patterns of radiographic diagnosis and treatment modalities. Most patients had a normal course of follow-up. Conclusion: Interpretation of CBCT volumes is a skill every dentist must possess. When reviewing large-volume CBCT scans, the clinician should be able to distinguish pathology from normal anatomic variations within the skull base. The majority of clivus variations are asymptomatic and will remain undetected unless incidentally noted on radiographic examinations.

Fibrous Dysplasia of the Clivus

  • Kim, Ealmaan
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.441-444
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    • 2010
  • Fibrous dysplasia (FD) of craniofacial structures is well documented, however, its involvement of the clivus is seldom described. We report a case of clival FD in a young man who presented with headache localized to the occipital area. The radiological studies revealed a monostotic disease confined to the clivus, with typical findings of hypo intensity on magnetic resonance images and ground-glass density on computed tomography. The diagnosis of FD was confirmed on pathological examination of specimens taken through transsphenoidal surgery. The patient showed reduction of symptoms and no change of residual lesion on follow-up imaging taken 2.5 years later after surgery. This study includes clinical aspect, radiographic appearance, differential diagnosis and treatment strategy of this rare skull base lesion.

Ectopic Growth Hormone-Secreting Pituitary Adenoma of the Clivus

  • Choi, Jae-Hyung;Park, Mi-Kyoung;Choi, Sun-Seob;Kim, Ki-Uk
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.306-309
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    • 2006
  • Ectopic pituitary adenoma, occurring outside the sella turcica without any continuity with intrasellar pituitary gland is very rare. So far, less than 90 such cases have been reported in the literature. Regarding to ectopic locations, suprasellar region, sphenoid sinus and clivus have been reported in decending order of frequency. To our best knowledge, growth hormone-secreting ectopic pituitary adenoma in the clivus has never been reported. With the pertinent literature review, we present our unique case with its characteristic magnetic resonance imaging and immunohistochemical features.

Surgical Approach of the Clivus and Anterior Cervical Spine (사대 및 전경추부의 수술적 접근법)

  • Tae Kyung;Lee Hyung-Seok;Park Chul-Won;Kim Kyung-Rae;Bak Koang-Heum;Kim Joo-Mook
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.172-176
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    • 1999
  • Background: An increasing number of traumatic, infectious, degenerative, benign, and malignant lesions of the clivus and cervical spine are treated by head and neck surgeons. Surgical techniques vary according to the exact level of the lesion. Objectives: The purpose of this article are to introduce the surgical approach and to discript our experience and to analyze the advantage of the each methods. Materials and Methods: Transpalatal approach in clivus chordoma, transoral approach in C2 fibrous dysplasia, trans mandibular approach in clivus meningioma and transcervical approach in neulilemmoma were reviewed from the medical record. Results: Postoperative complications occured. Otitis media with effusion were observed in transoral and trans mandibular approach. Cranial nerve paralysis was observed in transcervical approach. But other complications such as swallowing difficulty persisting over 6 weeks, malunion of mandible, orocutaneous fistula, hemorrhage from major vessel were not observed. Conclusion: The various surgical techniques to be described herein serve to give the best exposure of each level of the lesions. Therefore head and neck surgeon plays a major role in the treatment of lesion in the clivus and anterior cervical spine according to the lower incidence of postoperative morbidity.

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Effects of Slurry Composting and Biofiltration Liquid Fertilizer on Growth Characteristic of Poplar Clones in a Reclaimed Land Mounding Soil (간척지 성토지 식재 포플러의 SCB액비 처리에 따른 클론별 생장특성)

  • Park, Jung-Hyun;Yeo, Jin-Kie;Koo, Yeong-Bon;Lee, Won-Woo;Kim, Hyun-Chul;Park, Chi-Ho
    • Korean Journal of Soil Science and Fertilizer
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    • v.41 no.5
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    • pp.318-323
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    • 2008
  • We studied on the effects of slurry composting and biofiltration liquid fertilizer (SCBLF) on growth of two-year-old poplar clones planted in a reclaimed land mounding soil. The soil on the experimental site had lower concentrations of both exchangeable cations and salinity than before reclamation. However, the content of organic matter was low compared with the most soils. We applied SCBLF to the poplars six times and 5 L in each time for 80 days. Ten clones of six poplar species or hybrids were tested in this study: Populus alba ${\times}$ P. glandulosa(Clivus, 72-30, 72-31, Bongwha1), P. deltoides ${\times}$ P. nigra(Dorskamp), P. deltoides(Lux) ${\times}$ P. deltoides(Harvard)(97-19), P. euramericana(Eco28, I-476), P. nigra ${\times}$ P. maximowiczii(62-2) and P. Koreana ${\times}$ P. nigra var. italica(Suwon). Growth performance varied more among clones than among species. Average height growth of treated plots was 18% greater than control, and clones Clivus, 97-19, Eco28 and Dorskamp were more vigorous than other clones. Diameter at breast height in treated plots was 41% greater than control, and 97-19, Dorskamp, Eco28 and Clivus were the four best clones in this respect. Mean leaf area of treated trees was 26% greater for control trees. Chlorophyll content was similar between treated and controlled trees. Total nitrogen values in leaves were much higher in treated trees 18%. SCBLF treatment on poplars planted in reclaimed land helped tree growth.

Evaluation of canalis basilaris medianus using cone-beam computed tomography

  • Syed, Ali Z.;Zahedpasha, Samir;Rathore, Sonali A.;Mupparapu, Mel
    • Imaging Science in Dentistry
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    • v.46 no.2
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    • pp.141-144
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    • 2016
  • The aim of this report is to present two cases of canalis basilaris medianus as identified on cone-beam computed tomography (CBCT) in the base of the skull. The CBCT data sets were sent for radiographic consultation. In both cases, multi-planar views revealed an osseous defect in the base of the skull in the clivus region, the sagittal view showed a unilateral, well-defined, non-corticated, track-like low-attenuation osseous defect in the clivus. The appearance of the defect was highly reminiscent of a fracture of the clivus. The borders of osseous defect were smooth, and no other radiographic signs suggestive of osteolytic destructive processes were noted. Based on the overall radiographic examination, a radiographic impression of canalis basilaris medianus was made. Canalis basilaris medianus is a rare anatomical variant and is generally observed on the clivus. Due to its potential association with meningitis, it should be recognized and reported to avoid potential complications.

Sixth and Twelfth Cranial Nerve Palsies Following Basal Skull Fracture Involving Clivus and Occipital Condyle

  • Kim, Sung-Hoon;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.305-307
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    • 2012
  • Oblique basal skull fractures resulting from lateral crushing injuries involving both clivus and occipital condyle are rare due to their deep locations. Furthermore, these fractures may present clinically with multiple cranial nerve injuries because neural exit routes are restricted in this intricate region. The authors present an interesting case of basal skull fractures involving the clivus and occipital condyle and presenting with sixth and contralateral twelfth cranial nerve deficits. Clinico-anatomic correlations and the courses of cranial nerve deficits are reiterated. To the authors' knowledge, no other report has been previously issued on concomitant sixth and contralateral twelfth cranial nerve palsies following closed head injury.

Fossa navicularis magna detection on cone-beam computed tomography

  • Syed, Ali Z.;Mupparapu, Mel
    • Imaging Science in Dentistry
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    • v.46 no.1
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    • pp.47-51
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    • 2016
  • Herein, we report and discuss the detection of fossa navicularis magna, a close radiographic anatomic variant of canalis basilaris medianus of the basiocciput, as an incidental finding in cone-beam computed tomography (CBCT) imaging. The CBCT data of the patients in question were referred for the evaluation of implant sites and to rule out pathology in the maxilla and mandible. CBCT analysis showed osseous, notch-like defects on the inferior aspect of the clivus in all four cases. The appearance of fossa navicularis magna varied among the cases. In some, it was completely within the basiocciput and mimicked a small rounded, corticated, lytic defect, whereas it appeared as a notch in others. Fossa navicularis magna is an anatomical variant that occurs on the inferior aspect of the clivus. The pertinent literature on the anatomical variations occurring in this region was reviewed.

Evaluation of morphometric features of fossa navicularis using cone-beam computed tomography in a Turkish subpopulation

  • Magat, Guldane
    • Imaging Science in Dentistry
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    • v.49 no.3
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    • pp.209-212
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    • 2019
  • Purpose: Fossa navicularis is a bone defect in the clivus. Familiarity with this anatomical variant is important because it is close to vital anatomical structures in the base of the skull. The aim of this study was to determine the prevalence and morphometric properties of fossa navicularis within the clivus in a Turkish subpopulation using cone-beam computed tomography (CBCT). Materials and Methods: A total of 168 CBCT scans (female: 96, male: 71) were evaluated. High-quality CBCT images of patients without a syndromic condition or a history of neurological disease or surgery were included in the study. The prevalence, depth, length, and width of the fossa navicularis were performed. Results: The prevalence of fossa navicularis was 27.5% (n=46 patients). Sex was not associated with the depth, length, or width of the fossa navicularis (P>0.05). A significant positive correlation was found between age and length of the fossa navicularis(P>0.05). Conclusion: Fossa navicularis was found to be rare (27.5%). Anatomical variants of the skull base can also be clearly identified on CBCT images. The results of this study may be useful to radiologists, anatomists, and surgeons interested in the skull base.