Management of an extended clivus fracture: a case report.

BACKGROUND: Clivus fractures are highly uncommon. The classification by Corradino et al. divides the different lesions in longitudinal, transverse and oblique fractures. Longitudinal types are associated with the highest mortality rate between 67 - 80%. Clivus fractures are often found after high velocity trauma, especially traffic accidents and falls. The risk of neurologic lesions is high, because of the anatomic proximity to neurovascular structures like the brainstem, the vertebrobasilar artery, and the cranial nerves. Longitudinal clivus fractures have a special risk of causing entrapment of the basilar artery and thus ischemia of the brainstem. CASE PRESENTATION: This lesion in our patient was a combination-fracture of the craniocervical junction with a transverse clivus fracture. In this case, the primary closed reduction of the clivus fracture and the immobilization with a halo device was the therapy of choice and led to consolidation of the fracture. CONCLUSION: Therapy advices and examples in the literature are scarce. We present a patient with a clivus fracture, who could be well treated by a halo device. Through detailed research of the literature a therapy algorithm has been developed.

On-line monitoring of one-step laser fabrication of micro-optical components.

The use of an on-line monitoring method based on photoelasticity techniques for the fabrication of micro-optical components by means of controlled laser heating is described. From this description it is possible to show in real time the mechanical stresses that form the microelement. A new parameter, stressed area, is introduced that quantifies the stresses of a microelement during its fabrication, facilitating a deeper understanding of the physical phenomena involved in the process as well as being a useful test of quality. It also permits the stress produced in the manufacturing process and the optical properties of the final microelement to be correlated. The results for several microlenses monitored with this technique are presented.