CERVICAL SPINAL INJURIES IN MODERATE TO SEVERE HEAD INJURIES
AbstractBackground: Traumatic Brain Injury (TBI) is the leading cause of death in all age group. Theincidence of CSI increases with the severity of TBI so prompt care of cervical spine is necessary in allpatients with moderate to severe head injury. The objective of this study was to determine thefrequency of cervical injury in patients with moderate to severe head injury and different types oftrauma. Methods: This descriptive cross sectional study was conducted in department of NeurosurgeryAyub Medical College, Abbottabad from October 2011 to October 2012. A total of 369 patients wereincluded in this study by consecutive (non probability) sampling. All patients were subjected to X-raysand CT-Scan of the skull for evaluation of head injury. X-rays and CT scan with MRI of cervical spinewere done for evaluation of cervical spinal injury. Results: A total of 369 patients were included in ourstudy, out of which 276 (74.8%) were males and 93 (25.2%) were females. Age of the patients rangedfrom 3–90 years with mean of 31.93±21.35. Among these patients most common cause of injury wasfall 196 (53.1%), whereas the RTA was 159 (43.1%) and assault was 14 (3.8%). Out of the 369 patients42 (11.3%) were found to have cervical spinal injuries. Conclusion: The frequency of cervical injuryassociated with moderate to severe head injury remains the same in all over the world with minordifference in percentages; that we have observed in our study. Furthermore, we have observed thatcervical injury is directly proportional to the severity of head injury. All the head injured patients shouldbe suspected of having cervical spinal injury unless proved otherwise.Keywords: spinal injury, cervical injury, head injury.
Kamp MA, Slotty P, Sarikaya-Seiwert S, Steiger HJ, Hänggi D.
Traumatic brain injuries in illustrated literature: experience from
a series of over 700 head injuries in the Asterix comic books.
Acta Neurochir (Wien) 2011;153:1351–5.
Heskestad B, Baardsen R, Helseth E, Romner B, Waterloo K,
Ingebrigtsen T. Incidence of hospital referred head injuries in
Norway: a population based survey from the Stavanger region.
Scand J Trauma Resusc Emerg Med 2009;17:6.
Moppett IK. Traumatic brain injury: assessment, resuscitation
and early management. Br J Anaesth 2007;99:18–31.
Rasool T, Wani MA, Kirmani AR, Ramzan AU, Wani RA,
Imtiyaz S, et al. Role of methylprednisolone in acute cervical
cord injuries. Indian J Surg 2004;66(3):156–9.
Paiva WS, Oliveira AM, Andrade AF, Amorim RL, Lourenço
LJ, Teixeira MJ. Spinal cord injury and its association with blunt
head trauma. Int J Gen Med 2011;4:613–5.
Mulligan RP, Friedman JA, Mahabir RC. A nationwide review
of the associations among cervical spine injuries, head injuries,
and facial fractures. J Trauma 2010;68:587–92.
Gbaanador GB, Fruin AH, Taylon C. Role of routine emergency
cervical radiography in head trauma. Am J Surg
Holmes JF, Mirvis SE, Panacek EA, Hoffman JR, Mower WR,
Velmahos GC. Variability in computed tomography and
magnetic resonance imaging in patients with cervical spine
injuries. J Trauma 2002;53:524–9.
Wenger M, Adam P J, Alarcón F, Markwalder TM. Traumatic
cervical instability associated with cord oedema and temporary
quadriparesis. Spinal Cord 2003;41:521–6.
Torretti JA, Sengupta DK. Cervical spine trauma. Indian J
Tian HL, Guo Y, Hu J, Rong BY, Wang G, Gao WW, et al.
Clinical characterization of comatose patients with cervical spine
injury and traumatic brain injury. J Trauma 2009;67:1305–10.
Demetriades D, Charalambides K, Chahwan S, Hanpeter D, Alo
K, Velmahos G, et al. Non-skeletal cervical spine injuries:
epidemiology and diagnostic pitfalls. J Trauma 2000;48:724–7.
Santos EA, Filho WJ, Possatti LL, Bittencourt LR, Fontoura EA,
Botelho RV. Epidemiology of severe cervical spinal trauma in
the north area of São Paulo City: A 10-year prospective study.
Clinical article. J Neurosurg Spine 2009;11(1):34–41.
Lefler S. Evaluation of cervical spine in head injured pts.
Emergency Medicine & Critical Care 2007:16–7.
Kreykes NS, Ltton RW Jr. Current issues in diagnosis of
pediatric cervical spine injury. Semin Pediatr Surg
Ahmad M, Hussain SS, Malik SA. Two years review of facial
fractures at a tertiary care hospital in Islamabad, Pakistan. J
Liaquat Uni Med Health Sci 2008;7(1):7–12.
Singh A, Goyal N, Gupta DK, Mahapatra AK. An overview of
spinal injuries in children: series of 122 cases. Indian J
Neurotrauma 2011;8(1): 25–32.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.