Substantial head trauma: value of routine CT examination of the cervicocranium.
OBJECTIVE
To evaluate the usefulness of routine performance of computed tomography (CT) of the craniocervical junction in unconscious patients with substantial head injury.


METHODS
In a prospective study, CT of the head and the cervicocranium was performed in 202 patients with substantial cranial trauma (Glasgow Coma Scale scores of 3-6). Plain radiography was performed in all patients. Radiographs and CT scans were then blindly interpreted.


RESULTS
Twenty-eight patients (13.9%) had C-1 or C-2 fractures; plain radiographs did not demonstrate cervical fractures in 11 of these patients. Nine patients (4.4%) had fractures of the occipital condyles; plain radiographs did not demonstrate occipital condyle fractures in eight of these patients.


CONCLUSIONS
Because 5.4% of all patients had fractures of either C-1 or C-2 and 4.0% had occipital condyle fractures not seen at plain radiography, routine additional performance of CT of the craniocervical junction is useful in patients with substantial cranial trauma.
Link
T M
TM
Department of Clinical Radiology, University Hospital, Westfälische Wilhelms-Universität, Munster, Germany.
Schuierer
G
G
Hufendiek
A
A
Horch
C
C
Peters
P E
PE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000293:injuries; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging; D001270:Cervical Atlas / Q000000981:diagnostic imaging / Q000293:injuries; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000293:injuries; D011446:Prospective Studies; D016037:Single-Blind Method; D012887:Skull Fractures / Q000000981:diagnostic imaging*; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014474:Unconsciousness / Q000000981:diagnostic imaging