Whole-body computerized tomography and concomitant spine and head injuries

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• 作者：Jefferson Rosi Junior (1)
  Eberval Gadelha Figueiredo (1) ebgadelha@yahoo.com
  Edson Pedro Rocha (2)
  Almir Ferreira Andrade (1)
  Samir Rasslan (3)
  Manoel Jacobsen Teixeira (1)
• 关键词：Spine injury – ; Brain injury – ; Fracture – ; Vertebra – ; Whole ; body computed tomography
• 刊名：Neurosurgical Review
• 出版年：2012
• 出版时间：July 2012
• 年：2012
• 卷：35
• 期：3
• 页码：437-445
• 全文大小：488.3 KB
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• 作者单位：1. Division of Neurological Surgery, Hospital das Cl铆nicas da Faculdade de Medicina da Universidade de S茫o Paulo, Rua Eneas C Aguiar, 255, S茫o Paulo, SP, Brazil2. ICU of the Surgical Emergency Department, Hospital das Cl铆nicas da Faculdade de Medicina da Universidade de S茫o Paulo, S茫o Paulo, Brazil3. Department of Surgery, University of S茫o Paulo, S茫o Paulo, Brazil
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Neurosurgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1437-2320

文摘

The authors present a prospective study on the coexistence of spinal injury (SI) and severe traumatic brain injury (TBI) in patients who were involved in traffic accidents and arrived at the Emergency Department of Hospital das Clinicas of the University of Sao Paulo between September 1, 2003 and December 31, 2009. A whole-body computed tomography was the diagnostic method employed in all cases. Both lesions were observed simultaneously in 69 cases (19.4%), predominantly in males (57 individuals, 82.6%). Cranial injuries included epidural hematoma, acute subdural hematoma, brain contusion, ventricular hemorrhage and traumatic subarachnoid hemorrhage. The transverse processes were the most fragile portion of the vertebrae and were more susceptible to fractures. The seventh cervical vertebra was the most commonly affected segment, with 24 cases (34.78%). The distribution of fractures was similar among the other cervical vertebrae, the first four thoracic vertebrae and the lumbar spine. Neurological deficit secondary to SI was detected in eight individuals (11.59%) and two individuals (2.89%) died. Traumatic subarachnoid hemorrhage was the most common intracranial finding (82.6%). Spinal surgery was necessary in 24 patients (34.78%) and brain surgery in 18 (26%). Four patients (5.79%) underwent cranial and spinal surgeries. The authors conclude that it is necessary a judicious assessment of the entire spine of individuals who presented in coma after suffering a brain injury associated to multisystemic trauma and whole-body CT scan may play a major role in this scenario.