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

Radiologia Brasileira. 2019;(0) DOI 10.1590/0100-3984.2017.0154


Journal Homepage

Journal Title: Radiologia Brasileira

ISSN: 0100-3984 (Print); 1678-7099 (Online)

Publisher: Colégio Brasileiro de Radiologia e Diagnóstico por Imagem

LCC Subject Category: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine

Country of publisher: Brazil

Language of fulltext: Portuguese, English

Full-text formats available: PDF, HTML, XML



Silvia Squarza

Carla Luisa Uggetti

Marco Angelo Politi

Lorenzo Carlo Pescatori

Raffaele Bisogno

Adriana Campi

Paolo Reganati

Maurizio Cariati


Peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 28 weeks


Abstract | Full Text

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.