الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Traumatic Brain Injury (TBI) is the leading cause of death in all age groups in trauma patients. In various series, the mortality estimated to be, about 20–30%. According to severity the head injuries are 80% mild, 10% are moderate and 10% are severe. Mild traumatic brain injury (mTBI) is commonly known as concussion. Moderate TBI may cause misdiagnosis of cervical spine injury (CSI), which results into devastating long term consequences. It is stated that CSI with moderate TBI should be considered in each and every patient until proven otherwise. The incidence of CSI increases with the severity of TBI, so prompt care of cervical spine is necessary in all patients with moderate head injury.Once CSI is clinically suspected adequate cervical immobilization should be maintained and cervical radiography performed on a high priority basis. TBI due to automobile and pedestrian or motorcycle accident may be more likely to be the cause of CSI. In all patients with polytrauma and obtunded conscious level, CSI must be evaluated. Furthermore for excellent diagnosis of the cervical spine, CT scan and Magnetic Resonance Imaging (MRI) of the cervical spine should be done.
The aim of the work: to reveal the incidence of cervical injury in association with mild or moderate brain injury, identify the common types of trauma to facilitate prediction of cervical injury in trauma patient and decreasing its misdiagnosis.
Patients: 516 patients either gender above 18 years old who were presented by multiple causes of trauma with mild and moderate head trauma to the Mansoura University Emergency Hospital (MUEH), Patients with history of other cervical pathologies like Pott’s disease or malignancy were excluded from the study.
Methods: All trauma patients were assessed by primary survey using “ABCDE” approach, all polytrauma unstable patients were exposed in the resuscitation room to FAST, portable chest and pelvis x-ray, Initial resuscitation then full history taking, local and neurological examination. All trauma patient were investigated by CT Brain, Cervical plain radiographs and CT Cervical Spine to assess incidence of cervical spine injury with mild and moderate head trauma.
Results: 88.18% of the cases were males and 11.82% were females. When the study was divided into three age groups showed 48.64% of the cases was between 18 and 40 years, 42.25% of the cases was between 40 to 60 years and 9.11% above the age of 60 years. The most common cause of trauma was RTA 54.65%followed by MCA 20.56%. Other causes of trauma were FFH, struggle and FTG.74.22% had mild head trauma and 25.78% had moderate head trauma. ,65.5% were admitted for duration less than 7 days while the remaining 34.5% were admitted for duration ≥ 7 Days. mild head trauma,1.82% had associated spinal cord injuries while in the cases with moderate head trauma ,21.8% had associated spinal cord injuries with high level of significance between the two groups (p <0.0001).the younger age group was more suscepitable to head trauma and spinal injury than the elderly one.
Conclusion: RTA is the main cause of head trauma. The degrees of severity of head injuries are common in young adults as compared to the elderly. The incidence of cervical brain injury is increased with the presence of head trauma. The incidence of ICU and the duration of hospitalization are directly proportionate to the degree of head trauma.
Recommendations: Early stabilization of patients with suspected head trauma.All patients with head trauma should undergo brain CT and assessment of spinal cord injury. Strict observation and follow up of patients with head trauma with clinical positive findings on initial assessment. Further studies should be performed including larger number of patients. Further studies should be performed using advanced methods of assessment of spinal cord injuries.