Substantial head trauma: value of routine CT examination of the cervicocranium

Radiology. 1995 Sep;196(3):741-5. doi: 10.1148/radiology.196.3.7644638.


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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Axis, Cervical Vertebra / diagnostic imaging
  • Axis, Cervical Vertebra / injuries
  • Cerebral Hemorrhage / diagnostic imaging
  • Cervical Atlas / diagnostic imaging
  • Cervical Atlas / injuries
  • Cervical Vertebrae / diagnostic imaging*
  • Cervical Vertebrae / injuries*
  • Child
  • Child, Preschool
  • Craniocerebral Trauma / diagnostic imaging*
  • Female
  • Follow-Up Studies
  • Glasgow Coma Scale
  • Humans
  • Male
  • Middle Aged
  • Occipital Bone / diagnostic imaging
  • Occipital Bone / injuries
  • Prospective Studies
  • Single-Blind Method
  • Skull Fractures / diagnostic imaging*
  • Spinal Fractures / diagnostic imaging*
  • Tomography, X-Ray Computed*
  • Unconsciousness / diagnostic imaging