{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:21:51Z","timestamp":1794324111999,"version":"4.9.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2011,3]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Fractures of the clivus and traumatic diastases of the clival synchondroses are rare in the pediatric population. The incidence, outcome, and biomechanics associated with these fractures have been difficult to ascertain secondary to the lack of literature pertaining to their occurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Boolean search of the electronic medical record database at the Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, was performed to identify patients with fractures of the clivus that were diagnosed using CT of the head. A retrospective review of the chart and radiographic imaging was then performed to assess data regarding patient demographics, mechanism of injury, and skull and brain parenchymal injuries, as well as outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between May 2002 and November 2007, 16 patients with fractures of the clivus were identified. The mean age of these patients was 9 years (range 1\u201316 years). Eleven (68.8%) of the 16 patients had an associated traumatic diastasis of the central skull base. Five (31.3%) of the 16 patients died. However, of the 11 patients who survived, all had a good outcome with a Glasgow Outcome Scale score of 4 or 5 at the time of discharge. The incidence of clival fractures among patients with head injuries was 0.33%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clival fractures occur with a similar incidence in both the pediatric and adult trauma population. Outcome is not correlated directly with the extent of clival fracture, but rather with the presenting Glasgow Coma Scale score and concomitant brain parenchymal injuries. The identification of traumatic diastases in patients with clival fractures suggests that static loading forces are a significant factor in the biomechanics producing these types of fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2010.12.peds10190","type":"journal-article","created":{"date-parts":[[2011,3,3]],"date-time":"2011-03-03T02:18:41Z","timestamp":1299118721000},"page":"261-267","source":"Crossref","is-referenced-by-count":15,"title":["Fractures of the clivus and traumatic diastasis of the central skull base in the pediatric population"],"prefix":"10.3171","volume":"7","author":[{"given":"Pawel G.","family":"Ochalski","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Adamo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Albany Medical Center, Albany, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. David","family":"Adelson","sequence":"additional","affiliation":[{"name":"Pediatric Neurosurgery, Phoenix Children's Neurosciences Institute, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David O.","family":"Okonkwo","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian F.","family":"Pollack","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"},{"name":"Department of Pediatric Neurosurgery, Children's Hospital of Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0070261","series-title":"J Radiol","first-page":"863","article-title":"The persistence of a spheno-occipital synchondrosis in an adult","volume":"80","author":"Adem","year":"1999"},{"key":"b2-0070261","series-title":"Anat Rec A Discov Mol Cell Evol Biol","first-page":"38","article-title":"Assessing age-related ossification of the petrooccipital fissure: laying the foundation for understanding the clinicopathologies of the cranial base","volume":"282","author":"Balboni","year":"2005"},{"key":"b3-0070261","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1097\/00005373-199801000-00039","article-title":"Basal skull fracture with traumatic polycranial neuropathy and occluded left carotid artery: significance of fractures along the course of the carotid artery","volume":"44","author":"Carter","year":"1998"},{"key":"b4-0070261","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1227\/00006123-199010000-00015","article-title":"Fractures of the clivus: classification and clinical features","volume":"27","author":"Corradino","year":"1990"},{"key":"b5-0070261","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"364","DOI":"10.3171\/JNS-07\/08\/0364","article-title":"Incidence and pattern of direct blunt neurovascular injury associated with trauma to the skull base","volume":"107","author":"Feiz-Erfan","year":"2007"},{"key":"b6-0070261","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"645","DOI":"10.3171\/jns.2004.100.4.0645","article-title":"Bitemporal head crush injuries: clinical and radiological features of a distinctive type of head injury","volume":"100","author":"Gonzalez Tortosa","year":"2004"},{"key":"b7-0070261","series-title":"Clin Radiol","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/S0009-9260(61)80003-2","article-title":"Traumatic diastasis of cranial sutures","volume":"12","author":"Grossart","year":"1961"},{"key":"b8-0070261","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1148\/radiology.166.3.3340778","article-title":"Complex fractures of the clivus: diagnosis with CT and clinical outcome in 11 patients","volume":"166","author":"Joslyn","year":"1988"},{"key":"b9-0070261","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"660","DOI":"10.3171\/jns.1990.72.4.0660","article-title":"Clivus epidural hematoma. 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