The clinical histories and films of 50 patients having roentgenographic evidence of injury to the cervical spine were reviewed. Over half of these patients were noted to have injuries involving the upper cervical spine. This finding is at variance with some other series in which more injuries to the lower cervical spine were reported.14,16 Any history of head trauma, particularly those incidents in which force was applied to the vertex or anteroposterior aspect of the skull, should alert the physician to the possibility of associated injury to the cervical spine. The majority of cervical spine injuries with accompanying head trauma involved the upper segment (C1-C2).