C1-C2 fractures in asymptomatic elderly patients with minor head trauma: evaluation with a dedicated head CT protocol

• Main Authors: Silvia Squarza, Carla Luisa Uggetti, Marco Angelo Politi, Lorenzo Carlo Pescatori, Raffaele Bisogno, Adriana Campi, Paolo Reganati, Maurizio Cariati
• Format: Article
• Language: English
• Published: Colégio Brasileiro de Radiologia e Diagnóstico por Imagem 2019-01-01
• Series: Radiologia Brasileira
• Subjects: Craniocerebral trauma; Aged; Aged, 80 and over; Spinal injuries/diagnosis; Cervical vertebrae/injuries; Tomography, X-ray computed.
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842019005001101&lng=en&tlng=en

Abstract Objective: To evaluate the frequency and types of upper cervical spine injuries in asymptomatic elderly patients undergoing computed tomography (CT) for the investigation of minor head trauma. Materials and Methods: This was a prospective study of 2613 asymptomatic elderly patients with minor head trauma seen between January 2015 and December 2016. We adopted a dedicated head CT protocol that included the C1-C2 region. Results: Of the 2613 patients analyzed, 33 (1.26%) had upper cervical spine injuries, corresponding to 8.37% of the 394 patients with trauma-related findings. Of those 33 patients, 6 had C1 fractures and 27 had C2 fractures. The use of 16- and 128-slice scanners increased the CT dose by 25.0% and 23.7%, respectively. Conclusion: Inclusion of the C1-C2 region in head CT scans allowed us to identify upper cervical spine injuries in 1.26% of asymptomatic elderly patients with minor head trauma. The protocol evaluated helps detect potentially life-threatening injuries and could be adopted for routine use in elderly individuals with minor head trauma.