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the head, occipital condyles, atlas (C1), and axis (C2). After completion of the CT series, plain radiographs of the C-spine were obtained, including cross-table lateral, anteroposterior, open-mouth odontoid, and swimmer views. All images were immediately reviewed by the attending trauma surgeon, neurosurgeon, and radiologist. Then the films were blindly interpreted by two independent radiologists. Patients were observed for at least 2 weeks and were clinically reexamined after their mental status improved. Nine patients with equivocal scans were reimaged by CT using thinner cuts. Thirty-seven patients (18.3%) had a fracture above C3. No fractures were diagnosed by plain radiographs only. Nine patients had occipital condyle fractures, 8 of which were seen only on CT. Twenty-eight patients had fractures of C1, C2, or both, which were seen only on CT in 11 patients. Only 2 of 7 C1 fractures and 15 of 19 C2 fractures were visualized on plain radiographs. The authors recommended that CT of the upper cervical spine be performed routinely on patients who sustain head trauma and who have a significantly altered mental status.

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Author

Freeman Favors

Publisher

Elsevier Science; Elsevier ; Mosby Inc.; Elsevier BV (ISSN 1097-6760)

Published

1996

Language

EN

Field

Medicine (Health Sciences)