Radiology, Vol 196, 741-745, Copyright © 1995 by Radiological Society of North America
Substantial head trauma: value of routine CT examination of the cervicocranium
TM Link, G Schuierer, A Hufendiek, C Horch and PE Peters
Department of Clinical Radiology, University Hospital, Westfalische Wilhelms-Universitat, Munster, Germany.
PURPOSE: To evaluate the usefulness of routine performance of computed
tomography (CT) of the craniocervical junction in unconscious patients with
substantial head injury. MATERIALS AND 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. CONCLUSION: 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.
