Role of routine emergency cervical radiography in head trauma

• Published in: The American journal of surgery Vol. 152; no. 6; pp. 643 - 648
• Main Authors: Gbaanador, Gbaranen B.M., Fruin, Alan H., Taylon, Charles
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.12.1986; Elsevier
• Subjects: Accidents, Traffic; Adolescent; Adult; Aged; Biological and medical sciences; Child; Child, Preschool; Craniocerebral Trauma - classification; Craniocerebral Trauma - complications; Craniocerebral Trauma - diagnostic imaging; Craniocerebral Trauma - etiology; Emergencies; Female; Humans; Infant; Injuries of the nervous system and the skull. Diseases due to physical agents; Male; Medical sciences; Middle Aged; Radiography; Spinal Injuries - complications; Spinal Injuries - diagnostic imaging; Traumas. Diseases due to physical agents; Human; Radiography; Nervous system diseases; Radiodiagnosis; Craniocerebral; Neck; Emergency; Trauma
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/0002-9610(86)90441-1

This review of 406 patients with head injury examines the role of emergency cervical radiography in head trauma and the frequency of associated cervical spine injury. Of 293 patients who had emergency cervical radiography (72 percent), 8 showed some abnormality, but only 5 (1.2 percent) were significant for cervical spine injury. All eight patients were, however, clinically suspected to have associated cervical spine injury before emergency cervical radiography. One hundred thirteen patients (28 percent) did not undergo emergency cervical radiography based on clinical evaluation, and none was subsequently found to have a missed cervical spine injury. There was no correlation between severity of head injury and the presence of associated cervical spine injury (p > 0.16). Head trauma is infrequently associated with cervical spine injury and when present is usually not clinically occult. Emergency cervical radiography is not efficacious and should not be routine in the emergency room management of head trauma. When associated cervical spine injury is clinically suspected, adequate cervical immobilization should be maintained and cervical radiography performed on a low priority basis. Head injury due to automobile and pedestrian or motorcycle and automobile accident may be more likely to be associated with cervical spine injury.