SUBSTANTIAL HEAD TRAUMA - VALUE OF ROUTINE CT EXAMINATION OF THE CERVICOCRANIUM

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-l 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-I 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.