Muhammad Isa Hassan, Saleh Mohammed Kabir, Adamu Mansur Yahuza, Ismail Anas
Department of Radiology, Aminu Kano Teaching Hospital, Kano, Nigeria.
Department of Radiology, Bayero University, Kano, Nigeria.
J West Afr Coll Surg. 2024 Oct-Dec;14(4):359-363. doi: 10.4103/jwas.jwas_81_23. Epub 2024 Jul 18.
This study aimed to assess the prevalence of concomitant cervical spine and head injury at our University Teaching Hospital in Nigeria and attempted to justify examining patients' head and cervical spine using computed tomography (CT) scan at presentation irrespective of the head injury severity by clinical assessment using Glasgow Coma Scale (GCS).
All eligible patients, 1-80 years of age who presented with head injuries in the accident and emergency (A&E) unit during the study period, were included if they satisfied the inclusion criteria. Post-resuscitation GCS was assessed clinically, and head and cervical spine injury (CSI) were observed radiologically on cranio-cervical CT scan for all patients. The presence of cervical spine fractures, subluxation or dislocation was considered a confirmation of CSI.
There were 143 patients with head injuries studied; 90.2% of them were males. The mean age of the patients was 28.87 ± 15.93 years. The most common cause of injury was road traffic accidents in 110 (76.90%). The prevalence of CSI was 11.2%. Majority of the patients with CSI in this study (56.25%) had a mild head injury, 25% had a moderate head injury, and 18.75% had a severe head injury. The lower cervical spine was the most frequently injured segment in this study, involving 10 patients. Multi-level cervical vertebral body fractures of C3 to C6 were the most common form of CSI in this segment.
The prevalence of concomitant cervical spine and head injury was significant in this study. This was confirmed among study subjects with a clinical diagnosis of mild-to-moderate head injury as compared with moderate-to-severe head injury. Therefore, all patients who sustained a head injury irrespective of severity are required to have a complete and rapid evaluation of the cervical spine.
本研究旨在评估尼日利亚某大学教学医院颈椎与头部合并损伤的患病率，并试图论证，无论根据格拉斯哥昏迷量表（GCS）进行的临床评估显示头部损伤严重程度如何，患者就诊时均应使用计算机断层扫描（CT）对头部和颈椎进行检查。
研究期间，所有年龄在1 - 80岁、因头部损伤到急诊室就诊的符合条件的患者，若满足纳入标准则纳入研究。复苏后临床评估GCS，并对所有患者进行头颅 - 颈椎CT扫描以观察头部和颈椎损伤（CSI）情况。颈椎骨折、半脱位或脱位的存在被视为CSI确诊依据。
共研究了143例头部损伤患者；其中90.2%为男性。患者平均年龄为28.87 ± 15.93岁。最常见的损伤原因是道路交通事故，共110例（76.90%）。CSI患病率为11.2%。本研究中，大多数CSI患者（56.25%）为轻度头部损伤，25%为中度头部损伤，18.75%为重度头部损伤。下颈椎是本研究中最常受伤的节段，涉及10例患者。C3至C6多节段颈椎椎体骨折是该节段最常见的CSI形式。
本研究中颈椎与头部合并损伤的患病率较高。与中度至重度头部损伤患者相比，在临床诊断为轻度至中度头部损伤的研究对象中也证实了这一点。因此，所有头部受伤的患者，无论严重程度如何，都需要对颈椎进行全面快速评估。
