background petro-clival, clival and spheno-petro-clival tumours are still a neurosurgical challenge. usually, the classical skull base transpetrous approaches are employed, although they are burdened by an important rate of morbidity, and a very low rate of radical removal is reported. conclusions anterior transoral and transsphenoidal approaches are indicated for clival and spheno-petro-clival...

Background: Petro-clival, clival and spheno-petro-clival tumours are still a neurosurgical challenge. Usually, the classical skull base transpetrous approaches are employed, although they are burdened by an important rate of morbidity, and a very low rate of radical removal is reported. Objectives: We present our indications and results with minimally invasive transnasal and transoral approache...

The author describes four different approaches to clival tumours, and reviews his experience with 33 chordomas of the clivus. He also reviews his large experience with tumours invading the floor of the anterior and middle cranial fossae, and describes various surgical approaches for the removal of these tumours, followed by reconstruction of the bony floor with bone grafts, and dural reconstruc...

In a skull of an approximately 35-year-old belonging to the didactical collection of the University of Santa Cruz do Sul, Brazil, it was noted the clival canal of the occipital portion of the clivus (Figure). According to recent descriptions1, a clival canal was identified in 1.6% of skulls and there is limited information on bony canals in the occipital part of the clivus. Moreover, the presen...

Clival chordoma is a rare primary bone tumour that arises from the remnant of the notochord and typically occurs in older adults. Upon imaging, the tumour can be seen arising from the clivus and causes clival destruction. This usually provides insight for a diagnosis. Here we present a case of a non-enhancing, pre-pontine mass that was hypointense on T1W and hyperintense on T2W in an adolescent...

In some previous cases of clival bone fracture in patients with severe head injury, the diagnosis of clival bone fracture was relatively complicated. Regarding the incidence of clival fractures, some reports have shown an incidence of between 0.21% and 1.2% among traumatic brain injury victims who are admitted to hospital (1-3). The relationship between the site of the head and the type of frac...

Meningiomas as extra axial tumours, developing from arachnoid cap cells may occur from all dural structures, cranial and spinal and rarely outside of these structures (Whittle et al. 2004). The skull base is an area with multiple neural structures as well as brain supplying adjacent arteries and veins. Meningiomas, growing on or within the skull can thus be very challenging for the neurosurgeon...

Clival screw and plate fixation technique is an alternative or supplement to the occipitocervical instrumentation. However, no report has clarified the applied anatomy of clivus in patients with atlas assimilation (C1A), especially for clival screw fixation. Therefore, we measured the parameters of clival lengths, widths, putative screw lengths, clival-cervical angel and foramen magnum diameter...

An unusual case of entirely infrasellar craniopharyngioma mimicking a clival chordoma is described. Only 22 cases of craniopharyngioma with nasopharyngeal extension have been reported in the literature. Of the reported cases, most were primarily intracranial with secondary downward extension; only two were thought to originate from an infrasellar location. The present case is another example of...

Dural arteriovenous fistulas (dAVFs) may present in a variety of ways, including as carotid-cavernous sinus fistulas. The ophthalmologic sequelae of carotid-cavernous sinus fistulas are known and recognizable, but less commonly seen is the rare clival fistula. Clival dAVFs may have a variety of potential anatomical configurations but are defined by the involvement of the venous plexus just over...