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Updated: May 23, 2026
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Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Do concomitant cranium and axis injuries predict worse outcome? A trauma database quantitative analysis
Prashant Chittiboina1, Anirban Deep Banerjee, Anil Nanda
1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana.
Summary
Axis fractures with cranial injuries significantly worsen patient outcomes. Skull base trauma, in particular, is a strong predictor of poor prognosis, even with mild head injuries.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Trauma Surgery
Background:
- Axis fractures are common in trauma patients.
- Concomitant cranial injuries can affect outcomes.
- The impact of specific cranial injuries on axis fracture prognosis is not fully understood.
Purpose of the Study:
- To investigate the effect of concomitant cranial injuries on outcomes in patients with axis fractures.
- To identify specific cranial injury patterns associated with poor prognosis.
Main Methods:
- Trauma database analysis over a 14-year period.
- Inclusion of patients with axis fractures.
- Binary outcome measure (good vs. poor outcome).
- Univariate and multiple logistic regression analysis.
Main Results:
- 259 patients with axis fractures were identified.
- 57% had closed head injury; 14% had skull base trauma.
- Mortality rate was 6%; 72% had a good outcome.
- Abnormal CT head findings, skull base fractures, and visceral injury were associated with poor outcomes.
- Skull base injury independently predicted worse outcomes, regardless of head injury severity.
Conclusions:
- Skull base injury is a significant independent predictor of poor outcomes in axis fracture patients.
- Concomitant cranial and upper cervical spine injuries require careful evaluation due to poor prognosis.
