Abstract
The authors report a case of longitudinal fracture of the clivus associated with cerebrospinal fluid(CSF)rhinorrhea. The patient, a 58-year-old man, sustained an industrial accident in which he was hit in the occipital region. Initial computed tomography(CT)demonstrated an occipital skull fracture and acute subdural hematoma in the left frontal region as well as in the posterior fossa. his condition rapidly deteriorated, and an emergency craniotomy allowed the removal of both subdural hematomas. The patient regained consciousness a few days later and 6 days after his initial craniotomy, he experienced massive CSF rhinorrhea. CT, especially three-dimensional(3D)CT, revealed a longitudinal fracture of the clivus and fluid collection in the sphenoid sinus. The CSF leak ceased following trans-sphenoidal surgical repair. The longitudinal fracture of the clivus should be taken into consideration in patients with traumatic CSF fistula. This case appeared to be rare in that the traumatic CSF rhinorrhea was caused by a longitudinal fracture of the clivus.
