ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024
Concomitant trauma of brain and upper cervical spine: lessons in injury patterns and outcomes.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- The Burden of Concomitant Spinal Injury in the Setting of Traumatic Brain Injury that Required Admission to ICU-Lessons from a Tertiary Neurosurgery Center.Neurocritical care · 2026Article
- Inpatient Outcomes in Geriatric Complete Cervical Spinal Cord Injury: Associations Between Surgical Management and Reduced Mortality Despite Increased Morbidity.Global spine journal · 2026Article
- Sex and gender bias in major trauma care: a scoping review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Patterns of injury, management stratification, and inpatient outcomes in pediatric complete cervical spinal cord injury: insights from a national database.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- The effect of extended early rehabilitation on the treatment outcome of patients with moderate and severe traumatic brain injury.Frontiers in human neuroscience · 2025Article
- Early management of adult traumatic spinal cord injury in patients with polytrauma: a consensus and clinical recommendations jointly developed by the World Society of Emergency Surgery (WSES) & the European Association of Neurosurgical Societies (EANS).World journal of emergency surgery : WJES · 2024Article
- The acute phase management of traumatic spinal cord injury (tSCI) with polytrauma: A narrative review.Brain & spine · 2024Review
- The role of neurorehabilitation in neurotrauma: A global perspective.Journal of craniovertebral junction & spineArticle
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe literature on concomitant traumatic brain injury (TBI) and traumatic spinal injury is sparse and a few, if any, studies focus on concomitant TBI and associated upper cervical injury. The objective of this study was to fill this gap and to define demographics, patterns of injury, and clinical data of this specific population.
methodsRecords of patients admitted at a single trauma centre with the main diagnosis of TBI and concomitant C0-C1-C2 injury (upper cervical spine) were identified and reviewed. Demographics, clinical, and radiological variables were analyzed and compared to those of patients with TBI and: (i) C3-C7 injury (lower cervical spine); (ii) any other part of the spine other than C1-C2 injury (non-upper cervical); (iii) T1-L5 injury (thoracolumbar).
results1545 patients were admitted with TBI and an associated C1-C2 injury was found in 22 (1.4%). The mean age was 64 years, and 54.5% were females. Females had a higher rate of concomitant upper cervical injury (p = 0.046 vs non-upper cervical; p = 0.050 vs thoracolumbar). Patients with an upper cervical injury were significantly older (p = 0.034 vs lower cervical; p = 0.030 vs non-upper cervical). Patients older than 55 years old had higher odds of an upper cervical injury when compared to the other groups (OR = 2.75). The main mechanism of trauma was road accidents (RAs) (10/22; 45.5%) All pedestrian injuries occurred in the upper cervical injured group (p = 0.015). ICU length of stay was longer for patients with an upper cervical injury (p = 0.018). Four patients died in the upper cervical injury group (18.2%), and no death occurred in other comparator groups (p = 0.003).
conclusionsThe rate of concomitant cranial and upper cervical spine injury was 1.4%. Risk factors were female gender, age ≥ 55, and pedestrians. RAs were the most common mechanism of injury. There was an association between the upper cervical injury group and longer ICU stay as well as higher mortality rates. Increased understanding of the pattern of concomitant craniospinal injury can help guide comprehensive diagnosis, avoid missed injuries, and appropriate treatment.
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