- Radiological findings of reported cases of RPH.
| Authors | Modality | Findings |
|---|---|---|
| Smith et al27 | CT | Large homogeneous mass gradually occluding the airway at the level of hypopharynx. |
| Biby et al29 | CT | A severe prevertebral soft tissue swelling. |
| Kuhn et al31 | CT | I) 4 weeks later, soft tissue swelling occluding airway. II) Cervical spine revealed a C5 and C6 pedice fracture with subluxation and mild widening of the prevertebral soft tissue. Three days later, retropharyngeal soft-tissue swelling and prominent degenerative osteophytes anteriorly theat contribute to airway obstruction. III) Breakage from C1’s transverse process to C2’s lamina, a dens fracture, and a fracture of the transverse process of C3, with moderate prevertebral soft-tissue swelling. IV) Not stated. V) Not stated. VI) Complete fracture dislocation of C4 on C5 and extensive prevertebral soft-tissue swelling. VII) Significant degenerative alterations in the cervical spine and a 4-mm posterior displacement of C5 on C6. VIII) Widespread soft-tissue edema before vertebrae. |
| Daniello et al33 | CT | There is a large mass located in the retropharyngeal area that extends from the base of the skull to the top of the lungs. |
| Shaw et al34 | CT | The imaging showed a fluid-filled cavity in the retropharyngeal space that extended from the second to the sixth cervical vertebrae. The cavity was also found to be enhancing. |
| Mitchell et al35 | CT | Retropharyngeal hematoma with the trachea outlined only by the endotracheal tube. |
| Mazzon et al37 | CT | The imaging revealed a large hematoma that extended from the second cervical vertebra to the upper mediastinum. The hematoma occupied the entire pharyngeal and parapharyngeal space, and it caused compression of the upper larynx. |
| Cox et al38 | CT | The imaging showed that there was an occipital skull fracture that was not displaced, significant swelling of the soft tissue in front of the vertebrae, and compression of the airway from outside. |
| Senthuran et al39 | CT | The imaging revealed a significant mass in the retropharyngeal region on the left side, measuring 4 × 5 cm. The mass extended from the level of the hyoid bone to the left atrium, and it caused an indentation and anterior displacement of the trachea. Additionally, it blocks the left lower lobe bronchus. |
| Vakees et al41 | CT | The imaging showed a significant swelling of the soft tissue behind the trachea, which was consistent with a large hematoma that extended from the retropharyngeal and tracheal regions into the posterior mediastinum and base of the skull. |
| Kette et al42 | CT/MRI | CT: neck edema and hemorrhagic infarction of the peripharyngeal and perilaryngeal tissue, deformed upper airway, perivertebral muscular structures were no more recognizable, and vascular nervous fascia included within the mass without compressed, a discrete amount of air war documented at the level of perithyroidal. |
| MRI: cervical spine contusion at c3-c4 and c5-c6 levels in pre-existing vertebral spondylotic stenosis, the vertebral channel was stenotic, hemorrhagic infarction attributed to hematoma was documented at the same level prevertebral space. | ||
| Kettani et al43 | CT | According to the imaging, there was a hematoma that stretched from the fourth cervical vertebra to the upper mediastinum and filled the pharyngeal space, and the sixth cervical vertebra had a fracture. |
| Velde et al44 | CT | From the base of the skull to the superior mediastinum and the carina, there is a hematoma in the retropharyngeal area. Goiter is indicated by calcifications and nodules on the thyroid gland. |
| Shiratori et al45 | CT | The trachea is severely narrowed due to a large hematoma that extends from the pharynx to the point where the trachea splits into 2 branches. The narrowing is most severe at the level of the sternoclavicular joint, and the trachea has been pushed forward from its normal position. |
| Kochilas et al46 | CT | After 12 hours with intravenous contrast, it was suggested that the swelling was caused by a hematoma rather than soft tissue edema. |
| Suzuki et al47 | CT | The CT scan of the neck with 5 mm slices revealed that the retropharyngeal space is widened, and there is an obstruction in the upper airway. |
| Anagnostara et al48 | CT/MRI | CT: revealed a retropharyngeal collection that was hypoattenuating and located in the midline, anterior to the swollen prevertebral musculature. It extended from C1-C6 level. Additionally, there was an anterior displacement and compression of the parapharyngeal space, as well as lateral displacement of the carotid space, which were demonstrated bilaterally.The arytenoid cartilages were likewise somewhat shifted anteriorly, more caudally |
| MRI: following the absorption of the prevertebral edema, axial T1 and T2 weighted MRI scans at the level of the tongue base show that the airway has been cleansed. Retropharyngeal collection, which is T2 hyperintense and T1 hypointense, is barely discernible. | ||
| Chiti-Batelli et al49 | CT | A mass was identified in the mediastinum that is consistent with a hematoma extending to the carina. |
| Duvillard et al50 | CT | I) A retropharyngeal hematoma that is massive and extends from the second to the seventh cervical vertebra is present. II) A retropharyngeal hematoma is present between C3 and C7, which is causing a mass effect on the larynx, trachea, and pharynx without any vertebral fracture. |
| Freeman et al51 | CT | Imaging of the head was unremarkable. However, type I bilateral occipital condylar fractures with little displacement were found from C0-C2. |
| Lin et al52 | CT | Demonstrate the presence of a retropharyngeal hematoma that is obstructing the airway and causing breathing difficulties. |
| Sheah et al53 | CT | A massive low-density retropharyngeal hematoma that stretched from the base of the skull to the mediastinum was visible on the CT image. The suspicion was of extravagance. |
| Wyngaert et al54 | CT/MRI | The CT scan showed a fracture of the anterior arcus of the atlas and a bilateral fracture of the occipital condyles. Both bone fragments were displaced inferomedially towards the medulla. A type III OCF, according to the classification of Anderson and Montesano, was also detected. |
| MRI: the cervical epidural hematoma with obliteration of the anterior perimedullary space (curtain-sign) was discovered on the MRI, which also verified the OCFs. On the other hand, medullary pathology was not evident. | ||
| Lazott et al56 | CT/MRI | The CT scan showed bilateral fractures of the anterior arch of C1 and a fracture of the right C4 spinous process. Mild prominence of prevertebral soft tissues was noted without significant encroachment on the pharynx. |
| MRI: an expanding hematoma was the cause of the noticeable increase in the prevertebral soft tissue prominence seen on the sagittal T2-weighted MRI with fat saturation techniques. | ||
| Srivastava et al57 | CT | The CT scan revealed a fracture of the right C4 spinous process in addition to bilateral fractures of the C1 anterior arch. There was a slight prevertebral soft tissue prominence without a noticeable pharyngeal encroachment. |
| Tsai et al58 | CT | There was a massive hematoma visible on the CT scan that stretched from the base of the skull to the thoracic inlet. Both of the carotid arteries had extravasated contrast material inside of them as well as lateral displacement. |
| Birkholz et al59 | CT | Fracture of C2, extended retropharyngeal and mediastinal hematoma. The pharynx, the larynx, and the trachea were obstructed by the hematoma, suggestive for partial bilateral basal ganglia infarction. |
| Morita et al60 | CT/MRI | CT: a large hematoma that stretched from the superior mediastinal space to the retropharyngeal was visible on the CT scan. |
| MRI: at the C4-5 levels, a sagittal MRI (T2-weighted) showed anterior longitudinal ligament tearing. | ||
| Wronka et al61 | CT | The CT scan showed a type 2 fracture through the junction of the odontoid peg and body of C2. The body of C2 was displaced anteriorly by approximately 11 mm. There was an associated surrounding hematoma and soft tissue edema. |
| Pfeiffer et al62 | CT | confirmed that a large retropharyngeal haematoma narrowed the pharyngeal lumen. |
| Lin et al63 | CT | A large retropharyngeal hematoma that extended between the C2 and T4 vertebral body levels was visible on the CT scan. The trachea was compressed and moved as a result of the hematoma. |
| Ottaviani et al64 | CT | The CT scan showed a retropharyngeal hematoma measuring 7 cm by 3 cm on the right side. The hematoma caused a mass effect on the pharynx and larynx. Additionally, severe cervical spondylosis was present. |
| Senel et al65 | CT | A hypodense 3 x 1.5 cm region at the level of C2 and the left anterior border of the trachea was visible on the CT scan. There was a cannula inside the trachea, which was twisted to the right. |
| Jakanani et al66 | CT | The CT scan revealed a small retrolisthesis of C5 on C6, as well as a reduction in the C5/C6 disc interspace. A C5 lamina fracture that was consistent with a hyperextension injury was also discovered by CT scanning. |
| Nurata et al67 | CT/MRI | CT: the prevertebral spaces were wider, and the CT scan revealed an X-mm soft tissue mass compressing the trachea between C1 and C4. |
| MRI: on T2-weighted sagittal and axial MRI images, diffuse edema completely obscured the left retropharyngeal space. A retropharyngeal hematoma is consistent with the significant pharyngeal airway narrowing that resulted from this. | ||
| Iizuka et al68 | CT/MRI | The CT scan showed a brain contusion in the right frontal lobe, C4-7 right transverse process fracture, no visualization of the right vertebral artery, and extravasation of the contrast agent around the right transverse process fracture. |
| The MRI revealed a massive retropharyngeal hematoma located anteriorly, extending from the C1-T3 vertebrae. This was responsible for the sudden asphyxia. The same MRI also detected avulsion of the right lower cervical roots. | ||
| Paul et al69 | CT | Evidence of large retropharyngeal hematoma, measuring approximately 11 cm by 2.4 cm by 4 cm in size and causing severe compression of the adjacent airway |
| Thamamongood et al70 | CT | A soft tissue mass in the posterior mediastinum, retropharyngeal space, and bilateral carotid space was visible on the CT scan. It appeared isodense to hypodense. The mass compressed the upper esophagus posteriorly and extended caudally to the level of the eighth thoracic vertebra. |
| Park et al71 | CT/MRI | I) The CT scan showed no definite fracture or vessel injury. However, in the second CT, it revealed a prevertebral hematoma and a dark air density region at the C6-7 disc. There was no fracture or vascular injury on CT angiography. |
| MRI: the same patient’s T2-weighted sagittal MRI revealed a longitudinal mass in the retropharyngeal space from the C3 to T2 levels with heterogeneous signal intensity. The signal intensity was high for the C4 and C5 bodies. The same patient’s T1-weighted sagittal MRI revealed a low signal intensity mass in the retropharyngeal space. While the signal intensity at the upper C4 body was low, it was slightly higher at the lower C4 and C5 bodies. | ||
| II) Not possible due to poor compliance. | ||
| Calogero et al72 | CT | A sizable hematoma, measuring 6.7 cm transversely and 3.2 cm anteroposteriorly, is located in the retropharyngeal space. The hematoma is believed to have originated from the thyrocervical trunk and is situated posterior to the thyroid gland level. It measures 25 centimeters in length and begins at the level of the lower nasopharynx. It continues down the neck into the retropharyngeal space and into the mediastinum posterior to the esophagus. The hematoma causes esophageal compression in addition to anterior deviation of the larynx. Prevertebral soft tissue swelling is seen in the cervical spine, which causes the endotracheal tube to move anteriorly. Unintentionally, the abdomen revealed a 4.8 cm abdominal aortic aneurysm. |
| Kudo et al73 | CT/MRI | A retropharyngeal hematoma and C4/C5 dislocation were visible on the CT scan. Bilateral occipital watershed infarctions were seen on the MRI; they did not seem to be causing any symptoms. |
| Lowe et al74 | CT | Retropharyngeal hematoma |
| Betten et al75 | CT | The CT scan was normal, but a large retropharyngeal hematoma measuring 3.6 cm by 5.3 cm by 20 cm was detected. |
| Ren et al76 | MRI | A significant C4/5 and C5/6 disc herniation with severe spinal cord compression is visible on the sagittal cervical spine MRI. On T2-weighted images, there is an abnormally hyperintense signal in the spinal cord at the C5/6 level. A massive retropharyngeal hematoma that extends from the base of the skull to T1 is visible on the sagittal T2-weighted MRI 35 hours after surgery. This hematoma severely compresses the laryngopharynx and oropharynx posteriorly. A massive incisional hematoma between the trachea and carotid sheath is visible on the axial T2-weighted MRI. |
| Chang et al78 | CT/MRI | CT: I) a type II dens fracture (Anderson-D’Alonzo classification) and the Wackenheim line running behind the dens, indicating posterior AOD, were both visible on the CT scan. II) The CT scan additionally revealed a posterior AOD-indicating type II dens fracture with comminution (Anderson-D’Alonzo classification) and a running of the Wackenheim line behind the dens. A combined horizontal and sagittal split fracture of the C1 anterior arch and a type II dens fracture with comminution were identified on the coronal and axial reconstructed CT scans. Furthermore, a type II TAL injury was suggested by an avulsion fragment from the lateral mass of C1 and a widened right atlantodental interval seen on an axial CT scan. |
| MRI: increased anterior soft tissue swelling as a result of intramedullary hemorrhage and retropharyngeal hematoma was seen on the MRI. The axial MRI showed a type II TAL injury in accordance with Dickman’s classification and a midline sagittal split fracture of the C1 anterior arch. | ||
| Arai et al79 | CT | Massive retropharyngeal hematoma |
| Yu et al80 | CT | In the retropharyngeal space, a sizable hematoma that stretched from the base of the skull to the posterior mediastinum was discovered. Additionally, there was evidence of contrast leakage at the C6-7 vertebral level. |
| Iida et al81 | CT | There is a sizable hematoma measuring 53 × 145 × 25 mm in the retropharyngeal space. The patient also has a cervical spine spinous process fracture and a cervical fracture (C3). At the C7 vertebral body level, contrast agent extravasation was observed in the hematoma, which is compressing the hypopharynx and larynx. |
| Baek et al82 | CT/MRI | CT: no definite fracture or vessel injury was detected. However, an intense retropharyngeal hematoma was found. |
| MRI: a heterogeneous signal intensity mass in the retropharyngeal space is visible on the T2-weighted sagittal MRI. A mass with low signal intensity is visible in the retropharyngeal space on the T1-weighted sagittal MRI. | ||
| Kitai et al83 | CT | There was no evidence of a retropharyngeal space anomaly or spinal fracture. Nonetheless, fractures on the left fifth metacarpal and scapula were discovered. |
| Patel et al84 | CT | The nasopharynx and supraglottic larynx are effaced anteriorly due to opacification of the entire retropharyngeal (danger) tissue space (mean 65 HU), which stretches from the base of the skull to the mediastinum. This is caused by a noticeable mass effect. |
RPH: retropharyngeal hematoma, CT: computed tomography, MRI: magnetic resonance imaging, OCF: occipital condylar fracture, AOD: atlantooccipital dislocation, TAL: transverse atlantal ligament, HU: hounsfield units