Longitudinal clivus fracture associated with trapped basilar artery: unusual survival with good neurological recovery.

A 46-year-old motorcyclist sustained severe cranio-facial fractures from a fall at 60 km/h. He gradually developed a left hemiparesis and diplopia but retained a GCS of 15. CT head scan revealed a longitudinal clivus fracture. MRA of intracranial vessels identified a trapped basilar artery. The patient made an excellent recovery with residual left abducens palsy on follow-up at 10 weeks. Such recovery with minimal residual deficit in the context of this injury has not previously been reported. Reported cases to date are reviewed and causative mechanisms discussed.