Association of cervical spine findings on computed tomography in patients with blunt head injury: correlation with mechanism of injury

Chisama, Evance
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ntroduction: Blunt trauma to the head carries a greater risk of C-spine injuries due to the anatomical aspect of the region. However, this is influenced by a lot of factors which among them would be the mechanisms of injury. Understanding how the outcome of the C-spine injury is affected by the mechanisms of injury, this information could be used as predictor to C- spine injury hence prompt to further radiological investigations to patient with blunt head trauma. Objective: The study was performed to correlate the pathological findings involving the c-spine, as detected by CT in patients with blunt head injury and the mechanisms of injury Material and Method: Nine hundred and fifty CT scan reports of blunt trauma patient where CT brain and CT C-spine of the performed were retrospectively reviewed (75.58% male preponderance against 24.42% of females, mean age 34.96 range 18-96yrs).The major aspects of interest in this study were patients history of loss of consciousness, mechanisms of injury which was categorized into motor vehicle accidents, pedestrian vehicle accidents, assaults, falls and others, clinical findings of cervical spine tenderness and the initial GCS. Results: Of 950 cases, 53 (5.58%) showed acute spine injuries and only the mechanisms of injury showed significant association with the acute spine injuries (p=0.001). Furthermore, the linear regression model showed that among the mechanism of injury, the patient involved in motor vehicle accidents and pedestrian vehicle accident carried highest probabilities of acute spine injuries (6 folds and 2 folds respectively) as compared to the patients that were assaulted. Conclusion: The study demonstrates a low incidence of acute Cspine injuries in patient with blunt head trauma as detected on CT with mechanism of injury being the only statistically significant a predictive factor of acute C spine injuries.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in Diagnostic Radiology. Johannesburg, 2016