A rare case of retroclival epidural hematoma: case report and review of the literature

  • Manolo Piccirilli
  • Francesco PagliaEmail author
  • Maria Pia Tropeano
Original article


Retroclival epidural hematomas (REDHs) are rare and almost exclusively found in the pediatric age group. Frequently, the etiology is related to accidental trauma, though other mechanisms have been observed, including coagulopathy, non-accidental trauma, and pituitary apoplexy. A 76-year-old man was admitted to our emergency department after a loss of consciousness. He presented with a Glasgow Coma Scale of 13(E3V4M6). He complained of headache accompanied by nausea and vomiting. A computer tomography (CT) revealed a hemorrhage along the clivus and dens. Magnetic resonance imaging (MRI) demonstrated the retroclival hematoma in epidural space. At discharge headache resolved without medical or operative intervention. REDHs are likely underdiagnosed in adults and magnetic resonance imaging is superior for identifying these lesions. Atlanto-occipital dislocation should be considered in all cases of REDH. Most cases exhibit a benign clinical course with conservative management, surgical management is dictated based on the presence of hydrocephalus, brainstem compression, and occipitocervical instability.


Haematoma Clivus Epidural CT scan MRI 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article do not contain studies with animals by author.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  • Manolo Piccirilli
    • 1
  • Francesco Paglia
    • 1
    Email author
  • Maria Pia Tropeano
    • 2
  1. 1.Department of Neurology and Psychiatry, Neurosurgery‘Sapienza’ University of RomeRomeItaly
  2. 2.Department of NeurosurgeryHumanitas UniversityRozzanoItaly

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