The cervicocranium: its radiographic assessment.
Acute injuries of the cervicocranium (from the occiput to the second cervical intervertebral disk) may be radiographically obscure due to minimal displacement of fracture fragments, minor alterations of normal anatomic relationships (occipitoatlantal subluxation), or superimposition of normal skeletal structures. With the nasooropharynx adequately distended with air, the normal cervicocranial prevertebral soft-tissue contour is congruent with the anterior cortical margin of the cervicocranium; namely, concave above, convex anterior to, and concave below the anterior tubercle of C1. Alterations of the normal cervicocranial prevertebral soft-tissue contour due to hemorrhage into the retropharyngeal fascial space from subtle fractures or ligamentous injuries should prompt further assessment of the cervicocranium by means of computed tomography (CT). Cervicocranial CT prompted by an abnormal cervicocranial prevertebral soft-tissue contour has yielded a 16% positive injury rate, approximately three times the rate of acute cervical spine injuries reported in the literature.
Harris
J
J
Department of Radiology, University of Texas Medical School, 6431 Fannin, MSB 2.100, Houston, TX 77030, USA. john.h.harris@uth.tmc.edu
D000328:Adult; D001368:Axis, Cervical Vertebra / Q000293:injuries*; D001270:Cervical Atlas / Q000293:injuries*; D002574:Cervical Vertebrae / Q000293:injuries*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D019291:Skull Base / Q000000981:diagnostic imaging / Q000293:injuries; D012887:Skull Fractures / Q000000981:diagnostic imaging*; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed