Radiology, Vol 196, 741-745, Copyright © 1995 by Radiological Society of North America

ARTICLES

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.

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