Usefulness of routine cervical CT in high energy head injury patients. Fourteen cases of 'occult fractures' found during cervical CT scans

We routinely performed cervical CT scans in addition to head CT examinations on patients with blunt head traumas who had received high energy injuries. Although no fractures were seen on the plain films in 103 cases, the additional cervical CT examinations revealed 14 cervical fractures in 13 (12.6%) of these cases. We experienced an additional case, and here we report a total of 14 cases of 'occult cervical spine fractures'. For patients with blunt head traumas, a cervical CT examination is not usually performed if no evidence of a cervical fracture is found on plain films and no neurological deficits are present. Nevertheless, the present findings suggest that many cervical fractures may have been missed on plain films in the past, and the routine inclusion of a cervical CT examination might be appropriate for the evaluation of patients with blunt head trauma who have received a high energy injury. (author)