J Korean Neurosurg Soc.  2012 May;51(5):305-307. 10.3340/jkns.2012.51.5.305.

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

• Kim SH
• Kim SW

• KMID: 2066932
• DOI: http://doi.org/10.3340/jkns.2012.51.5.305

Abstract

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.

Keyword

Basal skull fracture; Cranial nerve palsy

MeSH Terms

Cranial Fossa, Posterior
Cranial Nerve Diseases
Cranial Nerve Injuries
Cranial Nerves
Head Injuries, Closed
Hypoglossal Nerve
Paralysis
Skull
Skull Fractures

Figure

• 

  Fig. 1 Detailed neurological examination of the patient. A : Patient shows right VI nerve palsy with restriction of lateral gaze. B : Patient shows left XII nerve palsy with tongue deviation.

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  Fig. 2 Computed tomographic scan of the patient. A : Sagittal computed scan (bone window) shows clivus fracture. B : Three dimensional computed scan reveals an avulsion fracture of the occipital condyle depressed around the foramen magnum.

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