title: Substantial head trauma: value of routine CT examination of the cervicocranium.
abstract: 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.
authors.affiliation: Department of Clinical Radiology, University Hospital, Westfälische Wilhelms-Universität, Munster, Germany.
authors.forename: T M
authors.initials: TM
authors.lastname: Link
authors.forename: G
authors.initials: G
authors.lastname: Schuierer
authors.forename: A
authors.initials: A
authors.lastname: Hufendiek
authors.forename: C
authors.initials: C
authors.lastname: Horch
authors.forename: P E
authors.initials: PE
authors.lastname: Peters
mesh_terms: 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