J Korean Neurosurg Soc.  2014 Dec;56(6):534-536. 10.3340/jkns.2014.56.6.534.

Pontomedullary Laceration, a Fatal Consequence of Skull Base Ring Fracture

• Jang JH
• Kim JS

• KMID: 2191154
• DOI: http://doi.org/10.3340/jkns.2014.56.6.534

Abstract

Due to improvements in emergency resuscitation provided by rescue teams, more trauma victims who could have died due to sudden heart failure at the scene are brought to the hospital following resuscitation. Most of these patients present with major organ injuries and hypovolemic shock at the time of trauma. However, head trauma associated with sudden heart arrest is rare. Here, we report a case of ring fracture with pontomedullary laceration that led to sudden heart arrest.

Keyword

Trauma; Resuscitation; Heart arrest; Fracture

MeSH Terms

Craniocerebral Trauma
Emergencies
Heart Arrest
Heart Failure
Humans
Lacerations*
Resuscitation
Shock
Skull Base*

Figure

• 

  Fig. 1 A and B : Skull base computed tomography, with bone windows, reveals a ring fracture involving the clivus, both petrous temporal bones and the posterior part of the foramen magnum. C : Skull base 3-D reconstruction computed tomography reveals no signs of atlanto-occipital dislocation, and the remainder of the cervical spine is intact.

• 

  Fig. 2 Brain magnetic resonance imaging, after 27 days of admission, shows swelling of the brain stem and cerebellum combined with transtentorial and foraminal herniation. There are also signal changes on the lower part of the pons and cerebellum, and pontomedullar continuity is not observed. M : midbrain, P : pons, Cbl : cerebellum, Sc : spinal cord.

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