[Concomitant vertebral trauma in patients with craniocerebral injuries. 34 consecutive patients over 3 years]

Between February 1986 and January 1989, a total of 430 inpatients with the diagnosis of a head injury were prospectively registered and analysed for the association of a spinal trauma. Of these patients, 92% (n = 396) suffered a primary coma and 8% (n = 34) a secondary coma. On admission the ratio of coma, somnolence, and mild clouding was 6:1:3. In 8% (n = 34) the head injury was combined with a lesion of the spinal column. The cervical spine was affected in two-thirds of the cases (21/34). The clinical outcome was subdivided into three categories: dead (n = 10), paraplegic (n = 12), and 12 other patients. At least 4 patients were disabled at the end of the observation period (hospitalized or receiving home care). It is discussed how to avoid overlooking associated spinal fractures in patients with head trauma and multiple injuries that all require emergency treatment.