Godtfredsen syndrome due to retroclival subdural hematoma
The present case has been published in the journal Neurology. A 30-year-old woman presented with sudden onset headache of 2 days duration. She was on warfarin 7.5 mg once a day owing to prosthetic heart valves INR of 3.5).

The patient had isolated bilateral 6th and left 12th cranial nerve palsies with sparing of the 5th nerve. Imaging showed a retroclival subdural hematoma extending from the posterior clinoid processes to the body of C2 vertebra, with compression of the brainstem.

The unique combination of 6th and 12th nerve palsies helps to localize the lesion to the clivus (Godtfredsen syndrome or clival syndrome). Of note, Godtfredsen had attributed the 6th nerve palsy to invasion of the cavernous sinus by nasopharyngeal carcinoma and the 12th nerve palsy to retropharyngeal lymph node metastasis.

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