Biomaterial Database

Prognosis and treatment of cervical spine injuries with associated head trauma. 1988

W I Steudel, and D Rosenthal, and R Lorenz, and W Merdes

Department of Neurosurgery, Johann-Wolfgang-Goethe-University, Frankfurt am Main, Federal Republic of Germany.

Pathological and biomechanical studies indicate that many injuries of the head and neck are to be considered as an entity, because cervical spinal fractures and head injuries are frequently combined. Depending on the localization and severity of the injury to the cervical spine, the incidence of an associated head trauma is reported in the literature as being between 6% and 63%. In 59 patients with cervical spinal fractures hospitalized in our department since 1980, we have examined the influence of head trauma on the prognosis and the management. Forty-three patients had fractures and/or dislocations in the lower cervical spine, and 16 had injuries in the upper region; head injuries were present in 33 (56 percent); minor injuries in 15, moderate and severe injuries in 10. Lesions requiring operation were a depressed skull fracture, extracerebral haematomas and scalp lacerations. Six out of 59 patients died; of these, four had suffered a severe head trauma. As a rule, surgery of the head and immobilization of the spine fracture were carried out as the first step followed by realignment of the spine with possible decompression and stabilization of the affected segment as a second step. CONCLUSIONS Fractures and/or dislocations of the cervical spine are frequently accompanied by head injuries. The severity of associated brain lesions has a marked influence on the prognosis. The correct identification of cervical lesions was delayed in about every second patient with minor head injury but rarely in comatose patients. In patients with altered consciousness an early spinal stabilization may be useful.

UI	MeSH Term	Description	Entries
D009333	Neck	The part of a human or animal body connecting the HEAD to the rest of the body.	Necks
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011379	Prognosis	A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.	Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D005500	Follow-Up Studies	Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.	Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006259	Craniocerebral Trauma	Traumatic injuries involving the cranium and intracranial structures (i.e., BRAIN; CRANIAL NERVES; MENINGES; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage.	Frontal Region Trauma,Head Injuries,Head Trauma,Occipital Region Trauma,Parietal Region Trauma,Temporal Region Trauma,Craniocerebral Injuries,Crushing Skull Injury,Forehead Trauma,Head Injuries, Multiple,Head Injury, Minor,Head Injury, Open,Head Injury, Superficial,Injuries, Craniocerebral,Injuries, Head,Multiple Head Injuries,Occipital Trauma,Open Head Injury,Superficial Head Injury,Trauma, Head,Craniocerebral Injury,Craniocerebral Traumas,Crushing Skull Injuries,Forehead Traumas,Frontal Region Traumas,Head Injuries, Minor,Head Injuries, Open,Head Injuries, Superficial,Head Injury,Head Injury, Multiple,Head Traumas,Injuries, Minor Head,Injuries, Multiple Head,Injuries, Open Head,Injuries, Superficial Head,Injury, Craniocerebral,Injury, Head,Injury, Minor Head,Injury, Multiple Head,Injury, Open Head,Injury, Superficial Head,Minor Head Injuries,Minor Head Injury,Multiple Head Injury,Occipital Region Traumas,Occipital Traumas,Open Head Injuries,Parietal Region Traumas,Region Trauma, Frontal,Region Trauma, Occipital,Region Trauma, Parietal,Region Traumas, Frontal,Region Traumas, Occipital,Region Traumas, Parietal,Skull Injuries, Crushing,Skull Injury, Crushing,Superficial Head Injuries,Temporal Region Traumas,Trauma, Craniocerebral,Trauma, Forehead,Trauma, Frontal Region,Trauma, Occipital,Trauma, Occipital Region,Trauma, Parietal Region,Trauma, Temporal Region,Traumas, Craniocerebral,Traumas, Forehead,Traumas, Frontal Region,Traumas, Head,Traumas, Occipital,Traumas, Occipital Region,Traumas, Parietal Region,Traumas, Temporal Region
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000063	Accidents, Traffic	Accidents on streets, roads, and highways involving drivers, passengers, pedestrians, or vehicles. Traffic accidents refer to AUTOMOBILES (passenger cars, buses, and trucks), BICYCLING, and MOTORCYCLES but not OFF-ROAD MOTOR VEHICLES; RAILROADS nor snowmobiles.	Traffic Collisions,Traffic Crashes,Traffic Accidents,Accident, Traffic,Collision, Traffic,Collisions, Traffic,Crashes, Traffic,Traffic Accident,Traffic Collision
D013123	Spinal Fusion	Operative immobilization or ankylosis of two or more vertebrae by fusion of the vertebral bodies with a short bone graft or often with diskectomy or laminectomy. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed, p236; Dorland, 28th ed)	Spondylodesis,Spondylosyndesis,Fusion, Spinal,Fusions, Spinal,Spinal Fusions,Spondylodeses,Spondylosyndeses
D013124	Spinal Injuries	Injuries involving the vertebral column.	Injuries, Spinal,Injury, Spinal,Spinal Injury
D013997	Time Factors	Elements of limited time intervals, contributing to particular results or situations.	Time Series,Factor, Time,Time Factor