naa a22 4500 510799663 CHVBK 20180411083349.0 cr unu---uuuuu 180411e20131001xx s 000 0 eng 10.1007/s12028-013-9831-4 doi (NATIONALLICENCE)springer-10.1007/s12028-013-9831-4 A Major Pitfall to Avoid: Retroclival Hematoma due to Odontoid Fracture [Elektronische Daten] [Sudhir Datar, David Daniels, Eelco Wijdicks] Background: Retroclival hematoma (RCH) is a rare occurrence. The hemorrhage is usually small and hidden and can be easily missed on CT scan. Here, we report the association of a RCH with an odontoid fracture. Methods: Case report and review of the literature. Results: We describe a case of a 75-year-old man with a history of squamous cell carcinoma of the tongue base, treated with chemo-radiation. He was on warfarin for atrial fibrillation. He presented to the hospital 6weeks after falling from standing height, with headache, neck pain, and stiffness. Clinical examination did not show any focal neurologic deficits. INR measured 4days before admission was 6.0, but therapeutic at 2.4 on the day of admission. CT scan of the head showed a RCH. CT angiogram of the neck unexpectedly showed a type II odontoid fracture with instability of the upper cervical spine and extension of the hematoma to the upper cervical spine. Anticoagulation was reversed with factor IX complex (Bebulin). He underwent C1-C2 fusion without any complications. The immediate post-operative period was unremarkable. Unfortunately, he succumbed to airway obstruction due to mucus plugging 14days into hospitalization. Conclusions: In the appropriate clinical setting, when a RCH is found, further imaging should be considered to rule out fracture of the cervical spine. Odontoid fractures can lead to compression of the spinal cord or lower medulla. To prevent neurologic injury and subsequent complications, prompt recognition of type II odontoid fracture should lead to immediate spine stabilization. Springer Science+Business Media New York, 2013 Retroclival hematoma nationallicence Odontoid fracture nationallicence Retroclival hemorrhage nationallicence Elderly nationallicence Fall nationallicence Cervical spine fracture nationallicence Anticoagulation nationallicence Datar Sudhir Department of Neurology, Mayo Clinic, Rochester, MN, USA aut Daniels David Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA aut Wijdicks Eelco Department of Neurology, Mayo Clinic, Rochester, MN, USA aut Neurocritical Care Springer US; http://www.springer-ny.com 19/2(2013-10-01), 206-209 1541-6933 19:2<206 2013 19 12028 https://doi.org/10.1007/s12028-013-9831-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9831-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Datar Sudhir Department of Neurology, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Daniels David Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Wijdicks Eelco Department of Neurology, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/2(2013-10-01), 206-209 1541-6933 19:2<206 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer