The value of skull and cervical spine radiography in patients following blunt head injury

• Published in: Nederlands tijdschrift voor geneeskunde Vol. 136; no. 48; p. 2366
• Main Authors: Quekel, L G, van der Kruijk, R A, Hekster, R E
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 28-11-1992
• Subjects: Adult; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - injuries; Craniocerebral Trauma - complications; Craniocerebral Trauma - diagnostic imaging; Female; Humans; Male; Radiography; Retrospective Studies; Skull - diagnostic imaging; Skull Fractures - diagnostic imaging; Skull Fractures - etiology; Spinal Fractures - diagnostic imaging; Spinal Fractures - etiology; Wounds, Nonpenetrating - complications
• ISSN: 0028-2162

In a consecutive series of 100 patients with blunt head trauma the efficacy of routine skull and cervical radiography was studied. Neurocranial and facial skeletal lesions were present in 8 patients, only 1 skull fracture being completely unsuspected clinically. In all 79 patients without cervical signs or symptoms the cervical spine films were within normal limits. Only two of the 21 patients with some form of local cervical spine symptomatology presented with traumatic changes. In 19 patients the cervical spine films did not demonstrate the cervicothoracic junction to satisfaction. Although this study confirms the low yield of routine conventional radiography in patients with blunt head trauma, the authors state that optimal conventional examination of the cervical spine is mandatory in all patients with blunt head trauma and the slightest suspicion of cervical symptoms or complaints and in those patients in whom either clinical examination or the clinical history is not completely satisfactory. The cervicothoracic junction should be adequately visualised. A CT or MRI scan of the brain should be preferred over conventional skull films in those patients in whom examination of the skull is considered indicated.